by Advize Admin | Jul 28, 2023 | Healthcare, Healthcare Law
The only government program that I can think of that did not authorize price negotiations for prescription medications was the Medicare Part D program. In its inception in 2006, price negotiations were not part of the law, and drug manufacturers were essentially at...
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...
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...
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 | Jun 10, 2022 | Healthcare, Technology
Tina Passione needed health insurance in a hurry in December. The newly retired 63-year-old was relocating to suburban Atlanta with her husband to be closer to grandchildren. Their house in Pittsburgh flew off the market, and they had six weeks to move out 40 years of...
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