In CMS
Nov 14th, 2018
Another opioid pill mill gets busted by the Medicare Fraud Strike Force. A “pain management clinic” in Hialeah, Florida, owned by David Bosch and Tania Sanchez, which operated under the name East Medical Office Inc., unlawfully distributed thousands of pills of oxycodone, during the period of April 2017-May 2018. It was a cash-only clinic, which remained ...
Sep 11th, 2018
Comments Off on OIG Work Plan: July 2018 Need-to-know Updates
Make time to compare your compliance efforts with OIG’s monthly work plan updates. It has been a year since the Office of Inspector General (OIG) changed its Work Plan format and began issuing monthly updates. The monthly breakdown provides updates and better transparency of the OIG’s efforts. Healthcare organizations and provider offices should take time ...
In Audit
Aug 21st, 2018
An OIG review shows Medicare overpaid outpatient hospitals as much as $25.8 million for complex simulations billed during audit period. Between 2013 and 2015, Medicare paid 1,193 hospitals $109,197,933 in bundled payments for intensity modulated radiation therapy (IMRT) — about $25,754,171 more than they should have, according to the Office of Inspector General (OIG). The ...
In Audit
Aug 16th, 2018
Improper payments stem from noncompliance. Hospitals do not always comply with Medicare requirements for reporting cochlear devices replaced without cost, according to a report issued by the Office of Inspector General (OIG). The U.S. Department of Health and Human Services branch office, charged with protecting program integrity, bases its conclusion on prior compliance reviews in which it identif...
In CMS
Aug 15th, 2018
If Congress and other stakeholders continue to drag their heels, Medicare bankruptcy is a real possibility. The Medicare Part A trust fund will be depleted by 2026 and Medicare Part B spending will grow more than 8 percent over the next five years, according to the 2018 Annual Report by Medicare’s Board of Trustees. Two things ...