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Officials throughout the country continue to crackdown on potential healthcare fraud cases. The primary motivator is one of the oldest and strongest: money. The feds get billions back from healthcare fraud cases every year. How do these cases work? The government is...
The saying about living in a fishbowl holds true for nurses. Those who are in this profession will often find that the public often view them from all sides, taking both their personal and professional lives into account when seeking care. In some cases, this will...
What type of case leads the government to call a rheumatologist one of the worst criminals when it comes to health care fraud? According to the U.S. Attorney for the Southern District of Texas, one that prescribes chemotherapy treatment for rheumatoid arthritis. The...
The Anti-Kickback Statute (AKS) makes it illegal to encourage referrals for Medicare services in exchange for renumeration or other types of payment. There are some exceptions, referred to as safe harbors. One example is the personal services and contracts safe...
Allegations of a Medicare overpayment are not uncommon. The government estimates that it overpays millions in Medicare claims to physicians and healthcare providers every single year. The government states these overpayments are of the result of a place-of-service...
The Department of Health and Human Services (HHS) recently announced that it is digging into risk adjustment tactics it claims may have led to overpayments. The review will focus specifically on certain Medicare Advantage (MA) plans. Secretary Xavier Becerra noted the...