AMA Releases 335 Coding Changes For 2019
The American Medical Association has released the 2019 Current Procedural Terminology code set. The code set was released Aug. 31, and the AMA announced the release Sept. 5. Six things [...]
Detroit Podiatrist Goes To Prison for Health Care Fraud
A Detroit-territory podiatrist was condemned to 28 months in jail today for his investment in a $1 million plan including podiatry benefits that were charged to Medicare however were never [...]
AMA Releases 335 Coding Changes For 2019
The American Medical Association has released the 2019 Current Procedural Terminology code set. The code set was released Aug. 31, and the AMA announced the release Sept. 5. Six things [...]
MGMA Opposes Proposal to Consolidate E/M Codes
Inside the proposed medical doctor price agenda, the facilities for Medicare & Medicaid services (CMS) positioned forth numerous coverage modifications on E/M documentation and fee. MGMA and a coalition of [...]
New York Doctor Imprisoned For $30M Scheme
Dr. Ewald Antoine pleaded guilty to healthcare fraud, as well as several other crimes. According to the indictment, Dr. Antoine posed as the owner of two clinics in Brooklyn, falsely [...]
Northwest ENT Associates, P.C. to pay approximately $1.2 million to resolve False Claims Act allegations
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
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
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 [...]
Whistleblower Sharing in Settlement from Prime Healthcare
A San Diego whistleblower will receive $17. 2 mil with the settlement of a 7-year-old false statements|lawsuit against Prime Healthcare Care regarding overbilling for Medicare services at California hospitals. Read [...]
Prime Healthcare Services To Settle False Claims Act Allegations
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 [...]