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Did Your Health Plan Rip Off Medicare?

Did Your Health Plan Rip Off Medicare?

by Advize Admin | Jan 27, 2023 | Compliance, FWA, Medical Record Auditing

Today, KHN has released details of 90 previously secret government audits that reveal millions of dollars in overpayments to Medicare Advantage health plans for seniors. The audits, which cover billings from 2011 through 2013, are the most recent financial reviews...
MA and Risk-Scoring, We Can Do Better (and Advize does)

MA and Risk-Scoring, We Can Do Better (and Advize does)

by Advize Admin | Dec 2, 2022 | Compliance, FWA, Medical Record Auditing, OIG Files

When you first open this article, the most glaring of things is the time frame from which the audit was derived.  2011-2013 data is at this point so aged, the calculation of $1,000 per patient enrolled in a Medicare Advantage (MA) as the overcharged amount is simply...
Kochanski and McFaul Take on Organized Fraud

Kochanski and McFaul Take on Organized Fraud

by Advize Admin | Oct 21, 2022 | Advize News, Compliance, Events

This week two of Advize Health’s own former HHS-OIG experts, Matt Kochanski and Wade McFaul presented a conversational webinar on Organized Fraud. Matt and Wade discussed their experiences with the types of fraud and various ways they investigated these cases. ...
Centene Agrees to Pay Massachusetts $14 Million Over Medicaid Prescription Claims

Centene Agrees to Pay Massachusetts $14 Million Over Medicaid Prescription Claims

by Advize Admin | Sep 30, 2022 | Compliance, FWA

Massachusetts has become the latest state to settle with health insurance giant Centene Corp. over allegations that it overbilled the state’s Medicaid program for pharmacy services, KHN has learned. Centene, the nation’s largest Medicaid managed-care insurer, will pay...
Some Rural Hospitals Are in Such Bad Shape, Local Governments Are Practically Giving Them Away

Some Rural Hospitals Are in Such Bad Shape, Local Governments Are Practically Giving Them Away

by Advize Admin | Aug 19, 2022 | Compliance, Healthcare

Kyle Kopec, Braden Health’s chief compliance officer, holds up a sample of diagnostic images left behind at a Tennessee hospital. As the company takes over abandoned hospitals, a major task is figuring out what to do with old medical records stacked in...
Cybersecurity for Mom and Pop Compliance Shops

Cybersecurity for Mom and Pop Compliance Shops

by Advize Admin | Jul 1, 2022 | Compliance, Events, Healthcare, Technology

Recently we presented to New York State Adult Day Services Association (NYSADSA) on this very topic.  For those of you who do not know, NYSADSA is comprised of individuals, single-site programs, multiple-site programs, professional organizations, and supporters...
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Recent Posts

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