Posted and filed under Healthcare Facepalm.
Posted and filed under Compliance.

HIPAA & Human Error

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…

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Posted and filed under FWA, Uncategorized.
Posted and filed under OIG Files.

OIG Files: The Importance of Quality Legal Representation

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…

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Posted and filed under OIG Files.

OIG Files: A Disastrous Investigative Misstep

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…

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Posted and filed under Healthcare.
Posted and filed under Healthcare.
Posted and filed under OIG Files.

OIG Files: The Mixing Bowl of Medication

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,…

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Posted and filed under FWA, Healthcare.
Posted and filed under Fraud, Healthcare.