Fraud, Waste and Abuse Fact: September

Affordable Care Act Fraud Criminals Facing Tougher Sentences Due to the Affordable Care Act, criminals convicted of fraud now face tougher sentences and more jail time. Criminals will receive 20 to 50 percent longer sentences for crimes that involve more than $1...

Clearing Up Some Eye Exam Confusion

How are eye exam codes defined? CPT includes four codes that specifically describe eye exams: 92002:  Medical exam and evaluation with initiation of diagnostic and treatment program; intermediate, new patient. 92004:  Medical exam and evaluation with initiation of...

What to Watch Out For With Credit Balance

In May 2014, the Department of Health and Human Services, Office of Inspector General (OIG) published a proposed rule updating its regulations. The proposed rule will authorize civil monetary penalties for “failure to report and return a known overpayment,” among...

Are you Ready for the Shift to ICD-10?

On July 31st, 2014, the U.S. Department of Health and Human Services (HHS) issued a rule finalizing Oct.1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10, the tenth revision of the...