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Nursing Home Owners Drained Cash During Pandemic While Residents Deteriorated

Nursing Home Owners Drained Cash During Pandemic While Residents Deteriorated

by Advize Admin | Feb 3, 2023 | FWA, Healthcare Facepalm

After the nursing home where Leann Sample worked was bought by private investors, it started falling apart. Literally. Part of a ceiling collapsed on a nurse, the air conditioning conked out regularly, and a toilet once burst on Sample while she was helping a resident...
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...
Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges

Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges

by Advize Admin | Dec 2, 2022 | Coding, FWA, Medical Record Auditing

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Summaries of the 90 audits, which...
Supreme Court to Hear Nursing Home Case That Could Affect Millions

Supreme Court to Hear Nursing Home Case That Could Affect Millions

by Advize Admin | Nov 11, 2022 | FWA, Healthcare

When Susie Talevski sued the agency that managed her elderly father’s care before he died, she hoped to get justice for her family. She did not expect the case would grow into a national bellwether. A ruling against her could strip millions of vulnerable Americans of...
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...
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Recent Posts

  • Nursing Home Owners Drained Cash During Pandemic While Residents Deteriorated
  • FDA Experts Are Still Puzzled Over Who Should Get Which Covid Shots and When
  • Did Your Health Plan Rip Off Medicare?
  • Meet Justine.
  • Money Isn’t Everything but the Audits and Investigations are Free

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