One-Two Punch: On Consecutive Days, DOJ Announces High Dollar Fraud and Abuse Settlements with Hospitals

By Conor Duffy on August 9, 2018

Posted in Fraud and Abuse, Government Enforcement, Hospitals and Health Systems, Medicare and Medicaid, Physicians and Allied Health Professionals, Reimbursement

The Department of Justice (DOJ) announced two significant False Claims Act (FCA) settlements in recent days that signal continued close government scrutiny of billing, coding and referral practices at hospitals.

On August 2, DOJ announced an $84.5 million dollar settlement with Michigan-based health system William Beaumont Hospital. The settlement resolves allegations of non-compliance with the…

CMS Announces Change to Student Documentation Requirement Intended to Reduce Burden on Teaching Physicians

By Conor Duffy on February 14, 2018

Posted in Academic Medical Centers, Fraud and Abuse, Government Enforcement, Hospitals and Health Systems, Medicare and Medicaid, Physicians and Allied Health Professionals, Reimbursement

On February 2, 2018, the Centers for Medicare & Medicaid Services (CMS) released Transmittal 3971 (Change Request 10412), which revises a section of the Medicare Claims Processing Manual (Manual), that provides guidance regarding billing for Evaluation and Management (E/M) services involving students. According to CMS, the Change Request is part of a broader goal to reduce the administrative burden on practitioners.
Continue Reading CMS Announces Change to Student Documentation Requirement Intended to Reduce Burden on Teaching Physicians

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One-Two Punch: On Consecutive Days, DOJ Announces High Dollar Fraud and Abuse Settlements with Hospitals

CMS Announces Change to Student Documentation Requirement Intended to Reduce Burden on Teaching Physicians

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