COMPLIANCE

OIG Calls on CMS to Do Better at Medicare Collecting Overpayments

The system Medicare uses to detect and recover overpayments isn't working as well as it should be, according to a new OIG report. The Overpayment Collection System CMS relies on special contractors … [Read more...]

OIG REPORT

CMS Dished Out $729.4 Million in Wrongful EHR Incentive Payments & We’re Going to Get that Money Back

Wrongful payments of Electronic Health Records (EHR) incentives are at the focus of two of the month's biggest stories in health care compliance. The first came down on May 31 when the Justice … [Read more...]

WHISTLEBLOWERS

Tool: Model Hotline Allegations Investigation Procedure

The OIG Model Compliance Plan for Clinical Laboratories requires labs to establish mechanisms for not only receiving but promptly investigating internal complaints and reports of potential compliance … [Read more...]

ENFORCEMENT

OIG Targets Sleep Study Tests

If your lab performs sleep studies on Medicare patients, beware. It is now a high-priority target for federal fraud and abuse enforcement. Here is a look at the risk you face and what you can do to … [Read more...]

LEGISLATION

New Laws: Civil Monetary Penalties Get More Expensive—and Easier to Dish Out

One aspect of the Affordable Care Act (ACA) that is not likely to be repealed is the enhancement of penalties for Medicare and Medicaid fraud and abuse. That includes the new Regulation on civil … [Read more...]

ENFORCEMENT

New OIG Rules Make It Easier to Sock Labs with Civil Monetary Penalties

It may be facing repeal but the Affordable Care Act (ACA) is not going down without a squawk. On Dec. 7, the Office of Inspector General (OIG) accomplished a key piece of ACA business by adopting … [Read more...]

COMPLIANCE

Labs Beware: New Rules Impose Harsher Civil Monetary Penalties

It may be facing repeal but the Affordable Care Act (ACA) is not going down without a squawk. On Dec. 7, the Office of Inspector General (OIG) accomplished a key piece of ACA business by adopting … [Read more...]

ENFORCEMENT

CMS Reports Medicare Fraud Prevention System Saves $1.5 Billion

By Kelly A. Briganti, Editorial Director, G2 Intelligence While Big Data can mean new opportunities for increasing efficiencies and revenues for the laboratory industry, the Centers for Medicare … [Read more...]

OVERPAYMENTS

Avoid False Claims Liability: CMS Clarifies How to Comply with 60-Day Deadline for Returning Medicare Overpayments

The Affordable Care Act requires labs, pathology groups and other providers to return overpayments to Medicare within 60 days of identifying the overpayment. Failing to comply with that deadline can … [Read more...]

Overpayments

CMS Final Rule Clarifies 60-Day Deadline for Returning Overpayments

Labs and other providers are required by a provision enacted in the Affordable Care Act to return overpayments to Medicare within 60 days of identifying the overpayment. Violations of the rule subject … [Read more...]


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