Reports of fraud and abuse in home healthcare make this benefit seem like the lawless wild west of government health insurance. Cruz Sonia Collado, for example, owner of Nestor Home Health in...
Lately I've noticed reports of fraud-related criminal prosecutions of those who work with doctors--from physicians' assistants and nurse practitioners to administrative staff and billing agents. Read more...
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Recent cases of proven and alleged fraud by executives raise the issue of how companies can anticipate and respond to this problem.
The Congressional Budget Office recently analyzed the budgetary effects of legislation intended to cut fraud in Medicare, Medicaid and the Children's Health Insurance Program. The federal government cut cut spending on benefits in these programs if legislation provided more funding or new authority to reduce fraud, the CBO estimated.
DaVita Healthcare Partners Inc. agreed to pay $350 million and forfeit another $39 million to settle allegations of paying kickbacks for patient referrals in violation of the False Claims Act the Department of Justice announced. DaVita is a Denver-based dialysis provider serving nearly 170,000 patients nationwide, according to The Denver Post.
Avoidable mistakes can compromise an investigation and aggravate problems under review. Former Department of Health and Human Services Inspector General Richard Kusserow has been asked so often to help fix investigative errors that he created a list of best practices.
An exception in the Stark Law for "in-house, ancillary services" was meant to make patient care more efficient; but when some practices started buying equipment to offer costly diagnostic tests and radiation therapy under the same corporate roof, testing became a cash cow that may have thwarted the intent of the law, according to The Wall Street Journal.
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Between implementing government initiatives and ensuring security of IT systems, it's easy to forget the importance of relationship building at all levels for hospital CIOs to achieve widespread success. That message, however, was delivered loud and clear by a trio of industry leaders at CHIME's annual fall forum.
Seventy percent of breaches involving the California healthcare industry were due to unencrypted data on lost or stolen hardware or portable media, a problem that strong encryption would fix, according to the latest data breach report from the state's attorney general.