Search for: "Physicians Auditing "
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19 Jan 2024, 7:09 am
It did so after an audit by the U.S. [read post]
8 Jan 2024, 10:00 am
A prior audit, issued in April 2022, found that the Department of Health’s (DOH) eMedNY claims processing system edits designed to prevent payments for services with an inactive OPRA provider were flawed, and Medicaid made $965 million in payments for 2.3 million OPRA services by physicians and professionals who were no longer actively enrolled in Medicaid on the service date. [read post]
8 Jan 2024, 10:00 am
A prior audit, issued in April 2022, found that the Department of Health’s (DOH) eMedNY claims processing system edits designed to prevent payments for services with an inactive OPRA provider were flawed, and Medicaid made $965 million in payments for 2.3 million OPRA services by physicians and professionals who were no longer actively enrolled in Medicaid on the service date. [read post]
2 Jan 2024, 10:01 am
A Florida appellate court found error in a judge of compensation court’s order requiring a claimant to pay one-half of the cancellation fee charged by the IME when the claimant appeared for the exam accompanied by a videographer and the physician refused to move forward with the examination [see Baptiste v. [read post]
22 Dec 2023, 2:31 pm
1984: An OPM audit of funds claims paid to a postal employee health care payor plan found that approximately $1,000,000 was improperly paid. [read post]
28 Nov 2023, 8:10 pm
Would you mind prepping some of our physicians? [read post]
28 Nov 2023, 8:11 am
When the insurance company tells you that they had your medical bills audited and are only paying half of them, will you know how to respond? [read post]
21 Nov 2023, 3:15 pm
A newly-announced settlement agreement and corrective action plan (the “Settlement”) between a prominent New York academic medical center and the U.S. [read post]
20 Nov 2023, 10:19 am
The government alleged that: (1) physicians were bribed with illeg [read post]
10 Nov 2023, 1:35 pm
quickly to implement and communicate 2024 health spending account (“HFSA”), high deductible health plan amounts relevant to determining eligibility to contribute to a medical savings account (“MSA”), adoption credit and exclusion limits, and other inflation-adjusted limitations relevant to the annual enrollment, withholding and other year-end tax and benefit planning of workers and their families to assist workers to take into account these adjustments during 2024 benefit… [read post]
9 Nov 2023, 1:48 pm
This involvement encompasses helping health care systems and organizations, group and individual health care providers, health plans and insurers, health IT, life sciences and other health industry clients prevent, investigate, manage and resolve sexual assault, abuse, harassment and other organizational, provider and employee misconduct and other performance and behavior; manage Section 1557, Civil Rights Act and other discrimination and accommodation, and other regulatory,… [read post]
9 Nov 2023, 1:07 pm
quickly to implement and communicate 2024 health spending account (“HFSA”), high deductible health plan amounts relevant to determining eligibility to contribute to a medical savings account (“MSA”), adoption credit and exclusion limits, and other inflation-adjusted limitations relevant to the annual enrollment, withholding and other year-end tax and benefit planning of workers and their families to assist workers to take into account these adjustments during 2024 benefit… [read post]
7 Nov 2023, 10:46 am
Risk Assessment, Auditing and Monitoring – OIG urges compliance programs to have a formal risk assessment process combined with active monitoring and periodic compliance audits as a way to discover and stifle compliance risk threats at an early stage before they can become violations of law. [read post]
5 Nov 2023, 3:10 pm
Because of inadequate audit controls, DADS was unable to determine how many unauthorized persons accessed individuals’ ePHI. [read post]
23 Oct 2023, 7:14 am
Develop affordable compliance steps like training webinars and audits focused on high-risk areas. [read post]
10 Oct 2023, 10:51 am
While AI offers numerous benefits in medical coding and billing, it's essential that physician practices, coders and billers approach its implementation with care. [read post]
5 Oct 2023, 5:00 am
DiNapoli announced the audits of State Departments, Agencies, Public Authorities and other entities listed below were issued. [read post]
5 Oct 2023, 5:00 am
DiNapoli announced the audits of State Departments, Agencies, Public Authorities and other entities listed below were issued. [read post]
8 Sep 2023, 8:24 am
These surveys and new oversight policies are in addition to the CMS’ proposed regulatory changes from June, further discussed in a recent client alert, and the recently finalized requirement that hospice-certifying physicians be qualified to treat Medicare beneficiaries. [read post]
21 Aug 2023, 4:30 am
Audit controls – regularly reviewing system activity, log files, etc. to identify irregular activity or potential compromises to PHI. [read post]
