Apr 8th, 2019
We’ve all heard of opioid addicts who make up aches and pains, fake injuries, or hurt themselves in hopes of being prescribed Vicodin, Percocet, etc. As the opioid crisis’ grows, so do its boundaries, with family pets becoming its next victims. For example, opioid addicted owners will sometimes hurt their pets to get a veterinary ...
Apr 1st, 2019
Although the scope of its enforcement is not yet determined, ensure your business relationships with laboratories do not violate EKRA. New Anti-kickback provisions in the Eliminating Kickbacks in Recovery Act of 2018 (EKRA) targets recovery homes, clinical treatment facilities, and laboratories that participate in illegal remuneration schemes. EKRA is Section 8122 of the Substance Use-Disorder ...
Medical necessity and documentation for these tests must meet both payer requirements and federal guidelines. Pain management drug testing is under the microscope for potential fraud, waste, and abuse. The reasons for scrutiny include misconceptions about what tests should be ordered, and the emergence of “pop-up labs” associated with drug rehabs (often, physicians or groups ...
In CMS
Mar 14th, 2018
We’ve seen a surge of Department of Justice (DOJ) takedowns of doctors who committed prescription fraud and abuse of opioid drugs. As prescription opioid addiction grows, so does the crackdown on abuse of federal dollars funding physicians who are feeding patient addiction. On March 9, 63-year-old Jerrold N. Rosenberg, MD, of Rhode Island was sentenced ...
New metrics and quality measures call for improved documentation to track this growing problem. Opioid dependence and overdose are at crisis levels. Healthcare professionals have a front row seat to this epidemic, and we have a responsibility to know coding and documentation requirements for such cases. Opioid Use Becomes a Quality Measure According to the ...