Granted our high school intern is smarter than most and has a brain for economics but still, we like to see what the younger generation thinks about the cost of healthcare… By Sophie Kowalewski Taking care of your body seems like an easy task, however, it’s not quite that simple. The healthcare market is a…
Since the start of the pandemic, the most terrifying task in health care was thought to be when a doctor put a breathing tube down the trachea of a critically ill covid patient. Those performing such “aerosol-generating” procedures, often in an intensive care unit, got the best protective gear even if there wasn’t enough to…
In 2012, the National Council on Prescription Drug Programs (NCPDP) made a change to the manner in which a compounded medication should be submitted to a Pharmacy Benefit Manager (PBM) for reimbursement. Previously, the requirement was to only list the most expensive ingredient, with reimbursement being made based on that line item. With the change,…
How is it possible that several years into the explosion of these schemes, can they still be there? It’s a bit of a rhetorical question, but one that certainly does spark discussion.
Faustino Bernadett, who was convicted in a $30 million kickback scheme that referred spinal surgeries to his hospital, is among those pardoned for “major, major crimes.”
The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. We hopefully are seeing the beginning of the end with COVID-19, but we will certainly not see…
The year 2020 was ripe with unprecedented challenges. Between a global pandemic, civil unrest, and rampant socio-political uncertainty…there was a lot to deal with. The healthcare industry was thrust into the spotlight, first for its heroes on the frontlines, then for its billing practices. COVID-19 put medical documentation under a microscope, examining everything from cause…
It’s more than money when your license is on the line. This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. This article continues a multi-part series that will be covering the top ten violations…
Healthcare providers have a lot on their minds. Between daily rounds, patient care, and an ongoing global pandemic – it’s not easy to stay on top of administrative tasks like documentation and medical record maintenance. Even so, medical record review is a critical function of the healthcare ecosystem. The reality is that there are a lot…
The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. A couple of weeks ago, the OIG issued a Special Fraud Alert regarding the use of speaker…