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OIG Posts a Resource Compliance Guide & Enforcement Action

You can use the links provided and go directly to the OIG material.

The OIG has developed free educational resources listed are to help health care providers, practitioners, and suppliers understand the health care fraud and abuse laws and the consequences of violating them. These compliance education materials can also provide ideas for ways […]

By |March 29th, 2017|Medical Coding Audits and Compliance, Medical Coding News and Recent Articles|Comments Off on OIG Posts a Resource Compliance Guide & Enforcement Action

1 in 4 health consumers have had their PHI stolen

26% of United States health consumers have had their PHI stolen from healthcare systems, according to the results of a study from Accenture, released in Orlando at HIMSS17. The study reveals that 50% of people who experienced such a breach were victims of medical identity theft, and thus had to pay an average of $2,500 […]

By |February 21st, 2017|Medical Coding News and Recent Articles|Comments Off on 1 in 4 health consumers have had their PHI stolen

Healthcare Provider will pay $60 Million Settlement for Medicare and Medicaid False Claims

TeamHealth Holdings, a major U.S. hospital service provider, has agreed to resolve allegations that it violated the False Claims Act by billing Medicare, Medicaid, the DHA, and the Federal EHB Program for higher and more expensive levels of medical service than what were actually performed (a practice also known as “up-coding”), the DOJ announced today. […]

By |February 13th, 2017|Medical Coding News and Recent Articles|Comments Off on Healthcare Provider will pay $60 Million Settlement for Medicare and Medicaid False Claims

Federal government reclaims $3.3B+ in fraudulent healthcare claims

The Office of the Inspector General has reported that the federal government has recovered over $3 billion in fraudulent healthcare claims in the 2016 fiscal year.

Read More Here

By |February 1st, 2017|Uncategorized|Comments Off on Federal government reclaims $3.3B+ in fraudulent healthcare claims

Texas Dental Management Firm Agree to Pay $8.45 Million to Resolve Allegations

Texas-based MB2 Dental Solutions (MB2), 21 pediatric dental practices affiliated with them, as well as their owners and marketing chief, all have agreed to pay the US and Texas Medicaid $8.45 million to settle allegations that they violated the False Claims Act. They are accused of knowingly submitting, or otherwise causing the submission of, claims […]

By |January 13th, 2017|Medical Coding News and Recent Articles|Comments Off on Texas Dental Management Firm Agree to Pay $8.45 Million to Resolve Allegations

Mother and Son Sentenced to Prison for Involvement in 95 Million Dollar Scam

A mother and son based in Miami were sentenced today to 120 months and 30 months in prison, respectively, for their roles in spearheading a $9.5 million health care fraud conspiracy that targeted Medicare Part D.

Read full story here: https://www.justice.gov/opa/pr/mother-sentenced-120-months-prison-son-sentenced-30-months-prison-involvement-95-million

By |November 21st, 2016|Medical Coding News and Recent Articles|Comments Off on Mother and Son Sentenced to Prison for Involvement in 95 Million Dollar Scam

Springfield Psychiatrist Ordered to Pay $908,000

SPRINGFIELD, Ill. – U.S. District Judge Sue E. Myerscough has entered judgment in favor of the government and against a Springfield psychiatrist, Duttala Obul Reddy, for $908,000, to settle allegations of false billing, as announced by U.S. Attorney Jim Lewis.

Read full story here: https://www.justice.gov/usao-cdil/pr/springfield-psychiatrist-ordered-pay-908000-civil-settlement

By |November 18th, 2016|Medical Coding News and Recent Articles|Comments Off on Springfield Psychiatrist Ordered to Pay $908,000

Detroit Area Home HealthCare Agency Co-owner Sentenced to 96 Months

The co-owner of a Detroit home health care company was sentenced today to 96 months in prison for his role in a Medicare fraud scheme that caused approximately $33 million in losses.

See the full story here: https://www.justice.gov/opa/pr/detroit-area-home-health-care-agency-co-owner-sentenced-96-months-prison-33-million-medicare

By |November 16th, 2016|Medical Coding News and Recent Articles|Comments Off on Detroit Area Home HealthCare Agency Co-owner Sentenced to 96 Months

Medical Device Maker Biocompatibles Pleads Guilty to Misbranding and Agrees to Pay 36 Million

Pennsylvania-based medical device manufacturer Biocompatibles Inc., a subsidiary of BTG plc, pleaded guilty today to misbranding its embolic device LC Bead and will pay more than $36 million to resolve criminal and civil liability arising out of its illegal conduct, the Justice Department announced today. LC Bead is used to treat liver cancer, among other […]

By |November 14th, 2016|Medical Coding News and Recent Articles, Uncategorized|Comments Off on Medical Device Maker Biocompatibles Pleads Guilty to Misbranding and Agrees to Pay 36 Million

Man Stealing Funds from SSA Pleads Guilty

ROANOKE, VIRGINIA – United States Attorney John P. Fishwick Jr. announced the guilty plea today of a man who was previously charged with stealing funds from the Social Security Administration.

See the full story here: https://www.justice.gov/usao-wdva/pr/vinton-man-pleads-guilty-federal-fraud-charge

By |November 10th, 2016|Medical Coding News and Recent Articles|Comments Off on Man Stealing Funds from SSA Pleads Guilty