A federal price transparency rule that took effect this year was supposed to give patients, employers and insurers a clearer picture of the true cost of hospital care. When the Trump administration unveiled the rule in 2019, Seema Verma, then chief of the Centers for Medicare & Medicaid Services, promised it would “upend the status quo to empower patients…
Many of us have visited a doctor’s office. And in many circumstances our doctors visit includes a follow up correspondence of some sort. Whether it was a medical assistant contacting a patient to set up his/her next doctor’s visit, or in some cases a follow up notification from your doctor informing you of the results…
Dr. Kingsley R. Chin was little more than a decade out of Harvard Medical School when sales of his spine surgical implants took off. Chin has patented more than 40 pieces of such hardware, including doughnut-shaped plastic cages, titanium screws and other products used to repair spines — generating $100 million for his company SpineFrontier,…
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 criminal, civil and administrative matters, it becomes clear that having…
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, investigations and referrals made by the state Medicaid agency to the Medicaid…
Granted our high school intern is smarter than most and has a brain for economics but still, we like to see what the younger generation thinks about the cost of healthcare… By Sophie Kowalewski Taking care of your body seems like an easy task, however, it’s not quite that simple. The healthcare market is a…
Since the start of the pandemic, the most terrifying task in health care was thought to be when a doctor put a breathing tube down the trachea of a critically ill covid patient. Those performing such “aerosol-generating” procedures, often in an intensive care unit, got the best protective gear even if there wasn’t enough to…
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 ingredient, with reimbursement being made based on that line item. With the change,…
How is it possible that several years into the explosion of these schemes, can they still be there? It’s a bit of a rhetorical question, but one that certainly does spark discussion.
Faustino Bernadett, who was convicted in a $30 million kickback scheme that referred spinal surgeries to his hospital, is among those pardoned for “major, major crimes.”