Last week, the Department of Justice (DOJ) announced a $516,718 false claims settlement related to improper billing of mid-level practitioner services...
CMS Medicare Advantage Final Rule Takes Aim at Risk Adjustment Coding
Yesterday, CMS released the Medicare Advantage (MA) Risk Adjustment Data Validation Final Rule. The Final Rule is intended to strengthen the acc...
OIG Fall 2022 Semiannual Report
The OIG has issued their Semiannual Report to Congress for the period April 1, 2022 through September 30, 2022. The report highlights over $4 billi...
OIG Targets Critical Care Services
The OIG has released a new audit report of critical care services. The audit revealed a significant error rate and identified the following deficien...
OIG Semiannual Report to Congress
The OIG has issued their Semiannual Report to Congress for the period October 1, 2021 through March 31, 2022. The report highlights nearly $3 billi...
The DOJ is Set to Increase Criminal Enforcement
The United States Attorney General recently discussed the 2022 priorities of the Department of Justice (DOJ). In his remarks he indicated the DOJ wi...
The 2021 Medicare FFS Improper Payment Report
The 2021 Medicare Fee-For-Service Improper Payments Report was released last week. The report is a valuable resource for healthcare compliance p...
OIG Semiannual Report to Congress
The OIG has issued their Semiannual Report to Congress for the period April 1, 2021 through September 30, 2021. The report highlights nearly...
OIG to Audit High Risk DRGs
The OIG has released the November update to their Work Plan. The most recent update includes plans to audit hospital claims billed with mechanical v...