HC Compliance Essentials

Latest HEAT Bust: Miami Man Admits to Fraudulent Testing Scheme

Conspiracy between workers and patients in a Detroit clinic cost Medicare nearly $5.4M. A resident of Miami, FL has conceded to submitting $7.42 million in false claims to Medicare in a fraudulent medical testing scheme, the Departments of Justice and…

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Facet Joint Injections, Ultrasound Services on OIG’s Radar Screen

Know what the OIG’s watching to make sure you’re billing properly. The OIG makes recommendations to CMS throughout the year explaining where they’ve found that the government is losing money on health care and offering recommendations on how to stop…

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Round-Up of the RACs’ New Issues

Tracheostomies, oxygen equipment are on the hit lists. The RACs recently posted a round of issues concerning procedures that were performed from Oct. 1, 2007 to the present. Region A: Diversified Collection Services (Connecticut, Delaware,…

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Physician Billing Compliance Question: Co-Pays

Question: We are having an issue in our office regarding 56441. The patient had a vaginal adhesion which was corrected simply in the doctor’s office. The problem is that the patient is getting charged a higher copay because of the…

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NJ Practice Busted for Providing PT, Claiming Surgeries

Modifier misuse, POS coding errors might be partly responsible for one physician’s legal troubles. A New Jersey practice allegedly overbilled Medicare by almost $5 million by fraudulently reporting lymphedema procedures to its carrier. Although the practice billed for surgery that…

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