by Advize Admin | Apr 9, 2021 | Providers
“Providers who may be reluctant to submit a claim for a higher level code, may in fact be taking an overly conservative approach, and submitting claims with a much lower code. ” Recently, former US Attorney for the Southern District of New York and...
by Advize Admin | Apr 1, 2021 | FWA
The Pennsylvania Insurance Fraud Prevention Association (IFPA) recently published their 2020 annual report. While reading through it, were really excited to see some of the great work that the SIU investigators at Highmark did on a case involving a physical...
by Advize Admin | Mar 5, 2021 | OIG Files
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...
by Advize Admin | Feb 26, 2021 | OIG Files
In previous articles, we have discussed some of the general law enforcement related activities that OIG Special Agents conduct; search warrants, arrests, HHS Secretarial Protection assignments and drug diversion investigations. Even with all of that being said,...
by Advize Admin | Jan 29, 2021 | FWA, Healthcare
…co-owner of numerous compounding pharmacies and pharmaceutical distributors, was sentenced today on his guilty plea to one count of conspiracy to commit health care fraud and one count of conspiracy to commit money...
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