In an exclusive interview, former Assistant U.S. Attorney in Florida Jeffrey Dickstein describes an investigation into billing practices for cardiac device implantations has altered compliance for hospitals and introduced a new approach for DOJ officials when tackling medical necessity cases.
Supreme Court justices heard opening arguments from several attorneys on Tuesday regarding the validity of implied certification theory in False Claims Act litigation.
Last week, Democratic presidential candidate Hillary Clinton made a surprising tweak to her position on healthcare, advocating for a buy-in program that would allow people 50 and older to purchase insurance through Medicare. In order for a "Medicare-for-more" program to succeed, policymakers must take a proactive approach toward Medicare's inflated improper payment rate, rather than treating it as an afterthought. Read more...
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The Centers for Medicare & Medicaid Services must allow recovery audit contractors to conduct prepayment review, the Government Accountability Organization recommends, citing higher recoveries than traditional pay-and-chase methodology.
Self-disclosure and self-correction will serve as key features of healthcare compliance programs as the industry navigates significant delivery reform in the coming years, Inspector General Daniel Levinson said during his keynote address at the 2016 Health Care Compliance Association's Compliance Institute.
Citing stagnant and declining fraud enforcement budgets, a new report from Deloitte University Press pushes government fraud fighters to adopt a "holistic approach" to fraud prevention that relies on data and predictive analytics to identify trends.
While it generally complied with federal improper payment reporting requirements, the Department of Health and Human Services fell short in several key areas, according to an independent audit conducted by Ernst & Young LLP.
In a new "Eye on Enforcement" video, the Office of Inspector General warns physicians to be wary of taking payments from other providers, highlighting a kickback concern the government has targeted over the last several years.
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In the usual physician-patient encounter, it's the doctor who has the power. But that can all change when the physician is at the receiving end of a racist rant from a patient, writes J. Nwando Olayiwola, M.D., in a reflection piece in the Annals of Family Medicine.
Not enough is being done to prepare internationally for pandemics, the World Health Organization warned at its 69 th World Health Assembly.