by Advize Admin | Jul 30, 2021 | Healthcare
Three years ago, pharma giant Pfizer paid $24 million to settle federal allegations that it was paying kickbacks and inflating sales by reimbursing Medicare patients for out-of-pocket medication costs. By making prohibitively expensive medicine essentially...
by Advize Admin | Jul 9, 2021 | Healthcare Facepalm
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...
by Advize Admin | Jun 25, 2021 | Healthcare
The Biden administration is quietly engineering a series of expansions to Medicaid that may bolster protections for millions of low-income Americans and bring more people into the program. Biden’s efforts — which have been largely overshadowed by other economic and...
by Advize Admin | Jun 18, 2021 | Healthcare
The pandemic-caused recession and a federal requirement that states keep Medicaid beneficiaries enrolled until the national emergency ends swelled the pool of people in the program by more than 9 million over the past year, according to a report released Thursday. The...
by Advize Admin | Jun 8, 2021 | Healthcare
The new head of the federal agency that oversees health benefits for nearly 150 million Americans and $1 trillion in federal spending said in one of her first interviews that her top priorities will be broadening insurance coverage and ensuring health equity. “We’ve...
by Advize Admin | Sep 9, 2020 | Compliance, Dental, Fraud, FWA
This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column next week for more examples of dental fraud from real cases! This article points out a unique aspect about dental fraud that has significant impacts on...
by Advize Admin | Sep 3, 2020 | Dental, Fraud, FWA, Medical Record Auditing
Our Founder and Managing Director Jeanmarie Loria sat down with retired OIG Special Agent Eric Rubenstein to discuss dental fraud, unscrupulous dentists, and the claims-related intricacies of the dental industry. Here’s how it went… JL: My aunt in California paid an...
by Advize Admin | Dec 20, 2019 | Community, Fraud, FWA, Healthcare
Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive...
by Advize Admin | Sep 18, 2019 | Fraud, FWA, Healthcare
Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive...
by Advize Admin | May 30, 2019 | Healthcare, Payers
As we approach the month of June, we also begin our downward slide towards the end of HEDIS season. HEDIS season, in all its glory, stretches through about 3 calendar seasons – and requires hard work from providers, chart reviewers, and record collection companies...
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