by Advize Admin | Aug 12, 2022 | OIG Files
If you missed Eric opining on LinkedIn this week, here are some quick pieces of information including: an infectious disease doctor, a case in NJ, and a Bill that was signed into law. Another great case from my former OIG coworkers in NJ. This one should concern...
by Advize Admin | Aug 5, 2022 | OIG Files
While CMS reported that is collected half of the overpayments previously identified by OIG, the OIG in another recent review (full report) found that number to substantially less. The OIG is the watchdog for HHS. All OIGs serve in this role for the respective...
by Advize Admin | Mar 25, 2022 | Healthcare Facepalm, OIG Files
I recently needed to get a CT scan done as part of a full physical examination. The ordering doctor and the imaging center are associated with a very large group in the Central Florida area. Upon leaving the visit with the physician, I was handed a hard...
by Advize Admin | Feb 18, 2022 | OIG Files
In some of my recent posts, I have mentioned the term “carouselling,” as it pertains to the recycling of diabetic testing supplies. I have had several people inquire about this term and how the scheme works. Carouselling Is the purchasing and reselling of...
by Advize Admin | Feb 11, 2022 | FWA, OIG Files
I spent about 25 years in federal law enforcement, and most of that time was as a Senior Special Agent at HHS-OIG. I loved working there, and I loved doing healthcare fraud investigations. When I was exploring retirement, and what I was interested in doing...
by Advize Admin | Jan 11, 2022 | OIG Files
For those of you who have been keeping up with the Elizabeth Holmes/Theranos trial, you likely have seen that there was a very mixed verdict. Holmes was convicted on some counts, acquitted on some and the jury was deadlocked on others. From a reader’s perspective, it...
by Advize Admin | Jul 9, 2021 | OIG Files
Actual Loss is defined as “reasonably foreseeable pecuniary harm that resulted from the offense.” Intended Loss is defined as “the pecuniary harm that the defendant purposefully sought to inflict.” For us that do not have a law degree, what does this all...
by Advize Admin | Jun 18, 2021 | OIG Files
We provide a lot of advisory and consulting services for the legal community. Our Former HHS-OIG Special Agents have that very niche experience in the ability to speak healthcare fraud, waste and abuse as well as legalese. In working with the various law firms on...
by Advize Admin | Jun 11, 2021 | OIG Files
Recently, Advize Health was involved in a matter pertaining to some medical record audits and investigations that were ongoing with a Social Adult Day Care (SADC), located on the West Coast. For a five year period, this SADC was the subject of audits,...
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...
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