In CMS
Oct 18th, 2018
The U.S. Government has stepped in to help with healthcare crisis in the wake of Hurricane Michael’s devastation. The death toll for Hurricane Michael is at least 29 people across Florida, Georgia, North Carolina, and Virginia. Florida’s Bay County is where the Category 4 hurricane made landfall last week. Rescuers and k-9s are still searching beneath piles ...
In CMS
Aug 13th, 2018
According to a Department of Justice (DOJ) U.S. Attorney’s Office Southern District of New York press release, Mustak Y. Vaid is the latest physician sentenced in a big Medicaid fraud ring involving six Brooklyn clinics between 2007 and 2013, who filled “prescriptions and referrals for medically unnecessary and/or non-existent tests and supplies.” He falsely posed ...
In Billing
Mar 14th, 2018
The Qualified Medicare Beneficiary (QMB) information in the Medicare remittance advice (RA) and Medicare summary  notice is being reintroduced; the issues preventing the processing of QMB cost-sharing claims by states and other secondary payers have been resolved. The simple fix was to include revised “alert” Remittance Advice Remark Codes in RAs for QMB claims without adopting other ...
In Audit
Feb 4th, 2018
By congressional request, the Office of Inspector General (OIG) prompted a series of audits, which investigated group home abuse and neglect of developmentally disabled residents. The findings were horrifying. According to their website, they “found that these residents often experienced serious injuries and medical conditions that resulted in emergency room visits,” and that “99 percent ...
In Billing
Dec 22nd, 2017
The Office of Inspector General (OIG) was busy in 2017. In the video, Eye on Oversight – 2017 Year in Review, released Dec. 20, the agency charged with protecting the integrity of U.S. Department of Health and Human Services (HHS) healthcare programs reflects on its accomplishments throughout the year. Summarizing the video, the OIG reports for ...