“As healthcare fraud, waste, and abuse continues to emerge, and poses more of a risk to organizational compliance, professionals should become familiar with some of the potential areas of noncompliance associated with telehealth.”
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Christi Grimm, the Inspector General of HHS, gave a recent keynote address to compliance professionals. In it, she said, “Simply put, the financial incentives created by risk adjustment may be driving upcoding in the severity of diagnoses to garner additional payments.”
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“It behooves all healthcare compliance professionals to be aware of the fraud, waste and abuse risks associated with telehealth services. This mode of delivery holds great promise. For it to fulfill that promise, non-compliance needs to be rooted out and corrected.”
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The recent surge in healthcare fraud has prompted heightened enforcement of the Anti-Kickback Statute (AKS). Government agencies are cracking down on illegal financial arrangements that jeopardize patient care. This article explores the significance of AKS enforcement, the impact on healthcare providers, and strategies for compliance in an evolving regulatory landscape.
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Urine drug testing overpayments drove up to $216 million in overpayments to Medicare over five years, according to a recent OIG audit report.
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Protect healthcare revenue: reduce the risk of fines and payback for inappropriate outlier payments created by unjustified price increases.
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Enforcement Actions: Sanctions and penalties for hiring excluded individuals in healthcare. Why is it crucial to avoid the risk of hiring excluded individuals? List of Excluded Individuals/Entities (LEIE)
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Complex and billed at a higher rate, OIG added physicians billing for critical care evaluation and management services to the work plan.
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Three corrective action plans demonstrate OCR’s expectations for HIPAA compliance. Equip the patient-facing team to meet OCR’s HIPAA Right of Access Initiative
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