Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Diagnostic Testing Done Wrong

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. For those of you who keep up with the latest and greatest in…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Genetic Testing

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. Fraud. It is everywhere; mortgage applications and loans, credit cards, you name it….

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Posted and filed under Compliance, Healthcare.

OIG Medi-Cal Audit Reveals $70M in Incorrect Payments

Earlier this month, the Office of Inspector General released a 29-page audit report of an investigation conducted on the California Department of Health Care Services. The audit, which covered the review of more than 112,000 Medicaid capitation payments amounting to nearly $74 million dollars was initiated to determine whether California had made capitation payments on…

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Posted and filed under Compliance, Fraud, FWA, Healthcare.

What Do You Hate Most About Healthcare?

Last night, Advize Health had the opportunity to present before one of the largest chapters of its kind in the United States. The audience, comprised largely of credentialed medical coders and billers who assemble to discuss their professional and issues within the industry, were given the opportunity to explore healthcare fraud from two different perspective….

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Posted and filed under Events, FWA, Medical Record Auditing.

ICYMI: 2018 OIG Work Plan Webinar

Advize Health’s first webinar of the new year will be broadcasting live today from 2:00PM EST until 3:30pm EST. The program will break down the 2018 OIG Work Plan and provide an in-depth examination at the OIG (Office of Inspector General) and their efforts in the fight against fraud. From mandatory requirements, to laws and…

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Advize Health’s 2018 OIG Work Plan Webinar

Advize is here to advise you! Join us for an exclusive webinar on the 2018 OIG Work Plan. Free to the first 500 participants, this webinar will be available on AdvizeU after the live broadcast for those who miss the cut off. This session will provide an overview of the 2018 OIG Work Plan responsibilities,…

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Posted and filed under Compliance, Healthcare, Payers.

The Road to Compliance

The road to compliance is long and bumpy, but a trip we must all take in 2018. In January 2017, compliance professionals from the Department of Health and Human Services (HHS), Office of Inspector General (OIG) held an assembly in which they discussed how to measure the efficacy of Compliance Programs. From this roundtable came…

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Posted and filed under Compliance, Fraud, FWA.

Don’t Get Ghosted by Your DME Supplier

Medicare fraud maintains its position among the fastest growing crimes in the United States. The government loses nearly $75 billion a year to Medicare fraud; which has led to the conception of several anti-fraud initiatives, including the OIG’s Operation Whack-A-Mole (WAM). Medicare fraud comes in many shapes and forms, with the three most popular including:…

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Posted and filed under Compliance, Healthcare, Payers.

HHS Retracts Support For Financial Assistance Charity

In an unexpected, albeit responsible move, Health and Human Services has retracted their support for a Patient Assistance Program. The Caring Voice Coalition (CVC) is a patient assistance charity that provides financial support to Medicare beneficiaries and other patients. Found in 2003 with seemingly noble intentions, the CVC was founded in 2003 to support patients…

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Posted and filed under Compliance, Healthcare.

2016 Update: OIG/OCR Audit Process

OCR’s Privacy, Security, and Breach Notification Audit Program: Although the ever-expanding use of health information technology in health care provides many benefits, in turn it poses new risks to consumer privacy. To ensure HIPAA compliance, HITECH requires HHS to perform periodic audits of covered entities and business associates. In 2011 and 2012, OCR conducted a…

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