Coding Compliance Risk

Medicare Advantage Supplier and Doctor to Pay $5 Million to Settle False Claims Act Allegations

By |2020-04-13T18:07:33+00:00August 14th, 2019|

Beaver Medical Group L.P. (BMG) and a doctor who works for it, Dr. Sherif Khalil, have agreed to pay a little over the amount of $5 million to resolve accusations [...]

Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2020

By |2020-04-13T18:07:41+00:00August 1st, 2019|

On July 29, 2019, the Centers for Medicare Services (CMS) issued a projected rule that has proposals to update payment policies, payment rates, and quality provisions for services equipped beneath [...]

$1.85 Million Paid to Settle Urology Modifier 25 Whistleblower Case

By |2020-04-13T18:08:11+00:00July 19th, 2019|

Separately asking routine evaluation and management (E/M) services provided on a similar day as another procedure is usually denied by Medicare. Care providers might typically individually bill E/M services if [...]

DOJ Pursues a Number Of EHR Cases: Five Things For You to Understand

By |2020-04-13T18:08:30+00:00June 21st, 2019|

The United States DOJ is initiating direct legal proceedings against Hospitals, Health Care systems, and Medical Technology Corporations for submitting an exhaustive number of false claims to both Medicare and [...]

Kansas Doctor Forks Over Almost 6 Million in Settling 3rd False Claims Case in Twenty Years

By |2020-04-13T18:08:51+00:00June 19th, 2019|

Joseph P. Galichia MD, the previous owner of the Wichita-based Galichia Medical, after quite some time, reached Fraud Claim Act settlements with the Feds in 2000 and 2009 amounting to [...]