CBRs are educational tools used to provide insight into billing trends. The intent is to assist healthcare providers when performing self-audits of both procedures and billing practices. The Centers for Medicare & Medicaid Services contracts with eGlobal Tech to identify topics and administer … [Read more...]
Florida contractor physicians’ group shares protected health information with unknown vendor without a business associate agreement
Advanced Care Hospitalists PL (ACH) has agreed to pay $500,000 to the Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) and to adopt a substantial corrective action plan to settle potential violations of the Health Insurance Portability and Accountability Act … [Read more...]
HIPAA Update on Enforcement
At the 2018 HCCA Compliance Institute HIPAA Policy and Enforcement Update, it was reported that since September 2009 through the end of 2017 there were 2178 reports filed with the HHS OCR involving breaches affecting 500 or more individuals. In addition to large breaches, there were over 300,000 … [Read more...]
Avoiding Medicare Fraud & Abuse: A Roadmap for Physicians Web-based Training
A revised Avoiding Medicare Fraud & Abuse: A Roadmap for Physicians Web-Based Training course is available through the Learning Management System - Opens in a new window . Learn about: Three types of physician business relationships that may raise fraud and abuse concerns Federal laws that … [Read more...]
Healthcare compliance enforcement is “full steam ahead”
The American Health Laywers Association reports that the Department of Health and Human Services Office of Inspector General (OIG) expects investigative recoveries of $1.46 billion for the first half of fiscal year (FY) 2018, the agency said in its semiannual report to Congress. Last year at this … [Read more...]
Ophthalmology Services: Questionable Billing and Improper Payments
The Office of the Inspector General (OIG) reports that Medicare is vulnerable to fraud, waste, and abuse for wet Age-related Macular Degeneration (wet AMD) and cataracts: Administration of Lucentis injections for wet AMD more than once every 28 days (based on local coverage determinations) … [Read more...]