GAO recommends reinstituting RAC prepayment reviews

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.


Inspector General: Self-disclosure key to healthcare compliance

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.

Report suggests adopting a holistic approach to fraud

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.

HHS misses key opportunities for improper payment recovery

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.


OIG to physicians: Be wary when doing business with other providers

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.


From Our Sister Sites


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.