You don’t have to be a coder to realize what the financial impact of proposed changes from the Centers for Medicare & Medicaid Services (CMS) will be, or to see [...]

The owner and managers of Arrow-Med Ambulance, Inc. plead guilty in connection with claims of fraud to Medicare and Medicaid. The accusation was of them using ambulances for medically unnecessary [...]

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 [...]

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 [...]

Scholastic and country healing centers will probably observe a cut in Medicare subsidizing if the CMS concludes a proposition to diminish repayment for more-complex patients, as indicated by a Moody's [...]

According to CMS, Evaluation and management (E/M) codes are the most frequently reported—and the most audited. In a study referred to by CMS, the OIG noted that 42% of claims for E/M services [...]

The MAG (Medical Association of Georgia), alongside the American College of Emergency Physicians, sued Anthem for payment denial of some emergency department services. Read full story here!

9 specialists from Southwest Orthopaedics (based in OKC) agreed to pay $670,000 to settle civil claims stemming from allegations they submitted false claims. Read the full story here!

The email account of a Montana Clinic employee was hacked in May while they were oversas, potentially compromising  the information of over 8000 patients. Read full story here!

CMS made a series of suggestions to expand telehealth in its latest Medicare Physician Fee Schedule and Quality Payment Program. Read full story here!