Coding Compliance Risk

Northwest ENT Associates, P.C. to pay approximately $1.2 million to resolve False Claims Act allegations

By |2020-04-13T18:36:37+00:00August 29th, 2018|

Northwest ENT Associates, P.C. (“Northwest ENT”), a Marietta, Georgia based professional corporation, has agreed to pay $1,195,361 to resolve allegations that it violated the False Claims Act by submitting claims [...]

California Physician and Practice Settle False and Fraudulent Claims Case

By |2020-04-13T18:36:46+00:00August 27th, 2018|

On June 11, 2018, James S. Dunn, Jr., MD, d/b/a Auburn Urogynecology and Women's Health (collectively, "Dr. Dunn"), Auburn, California, entered into a $419,578 settlement agreement with OIG. The settlement [...]

Providence Health Sued Over Alleged $188 Million Medicare Upcoding Scheme

By |2020-04-13T18:36:54+00:00August 21st, 2018|

Providence Health and Services has been hit with a lawsuit alleging the health system violated the False Claims Act by purposely upcoding Medicare to increase reimbursement. The lawsuit, filed late last [...]

Prime Healthcare Services To Settle False Claims Act Allegations

By |2020-04-13T18:37:11+00:00August 17th, 2018|

Prime care Services, Inc., Prime care Foundation, Inc., and Prime care Management, Inc. (collectively Prime), and Prime’s Founder and Chief exective officer, Dr. Prem Reddy, have united to pay the u. s. $65 million to settle allegations that fourteen Prime hospitals in Calif. wittingly submitted false [...]

eClinicalWorks Fined For Failing To Comply With DOJ Settlement Agreement

By |2020-04-13T18:37:44+00:00August 7th, 2018|

The Inspector General of the Department of Health and Human Services fined eClinicalWorks $132K for violating a 2017 agreement which had required them to report patient safety issues with its EHR [...]

OIG Estimates Medicare Improper Payments at $3.7 million

By |2020-04-13T18:13:26+00:00August 6th, 2018|

The Office of Inspector General (OIG) reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that lacked corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation of these claims to determine if the services met Medicare’s [...]