Coding Compliance Risk

Repeal of MIPS – Recommendation to Congress, MedPAC 12 to 4 Vote

By |2020-04-13T18:21:59+00:00January 13th, 2018|

A top Congressional advisory body has voted to recommend that Congress repeal the Merit-based Incentive Payment System (MIPS) and replace it with a simpler quality reporting system that would not [...]

Charleston dentist sentenced to five years in federal prison for health care fraud

By |2020-04-13T18:18:40+00:00December 18th, 2017|

A Charleston dentist who falsely billed West Virginia Medicaid for more than $700,000 was sentenced today to 5 years in federal prison. Skaff, a dentist, admitted that he falsely inflated his billings [...]

Utah Pain Doctor and Medical Practice Settle Medicare Fraud Claims

By |2020-04-13T18:18:51+00:00November 5th, 2017|

On July 21st, 2017, Jahan Imani, M.D., and Intermountain Medical Management, P.C., (IMM), a Utah based pain management specialist and his practice, entered into a $399,895.92 settlement agreement with OIG. [...]

Syracuse Area Medical Practice Improperly Billed for Moderate Sedation Services

By |2020-04-13T18:19:00+00:00November 1st, 2017|

New York Spine and Wellness Center (under the umbrella of New York Anesthesiology Medical Specialties, P.C.) agreed today to pay $1,941,850.29 to resolve allegations that it improperly billed for moderate [...]

Under Michigan’s New Medicare RAC Regime, Physician Services Are the Initial Primary Target

By |2020-04-13T18:19:08+00:00September 5th, 2017|

An announcement came back in back in October 2016 from the Centers for Medicare & Medicaid Services (CMS). It announced that it had awarded to various entities the next round [...]

Civil Fraud Case Settlement from Fredericksburg Hospitalist Group amounts to $4.2 Million

By |2020-04-13T18:19:20+00:00September 1st, 2017|

Along with 14 of its member shareholders, Fredericksburg Hospitalist Group has agreed to pay nearly $4.2 million to settle a federal False Claims Act case brought under the qui tam [...]

Due to Improper Billing, Healey Returns $500,000 in Settlement With a Springfield Dentist

By |2020-04-13T18:19:43+00:00August 25th, 2017|

Massachusetts Attorney General Maura Healey announced today a settlement with a pediatric dentist in Springfield. Healey's office returned $500,000 to MassHealth, the state’s Medicaid program, resolving claims that improper billing [...]

Hospital in Macon will pay $2.5 million to settle billing allegations

By |2020-04-13T18:19:55+00:00August 7th, 2017|

The Navicent Health Medical Center has agreed to pay $2.5 million to settle federal allegations that it submitted bills for ambulance trips that were either medically unnecessary or inflated. The [...]