Medicare Compliance & Reimbursement
MEDICARE/MEDICAID CLAIMS AREN'T THE ONLY FCA TARGETS
Health care providers should keep in mind that Medicare and Medicaid aren't the only government payers for which billing snafus could get you saddled with hefty False Claims Act fines. TRICARE, the Department of Defense's health care program for military personnel has it own set of rules, and if you run afoul of them a whistleblower could put the feds on your trail. Case in point: McKinney, TX-based device manufacturer Orthofix Inc. agreed to pay more than $1.5 million to settle allegations that it submitted false claims to TRICARE, the Department of Justice reports. Filed by former Orthofix employee Karen Neel, the suit claims that Orthofix billed TRICARE for electrical bone growth stimulation product Physiostim for use on the cervical spine. The problem: The Food and Drug Administration hasn't approved Physiostim for cervical spine treatment. The settlement represents about twice the amount of the overcharge, according to Nolan. Neel will collect 18 percent of the settlement proceeds - about $283,000 - for her role as whistleblower.
Medicare Compliance & Reimbursement
- Medicare Reform:
GOP LEADERS' MEDICARE DEADLINE PASSES SANS DEAL
To no one's surprise, House and Senate negotiators failed to produce compromise legislation revamping Medicare [...] - DME:
SUPPLIER-NUMBER FREEZE DEVASTATES DME PROVIDERS
Earliest issuances slated for Nov. 1, for lucky few. Durable medical equipment suppliers waiting on [...] - HIPAA:
7 KEY STEPS FOR HIPAA CONTINGENCY PLANNING
CMS tips its hand as to what it expects from providers who aren't ready for [...] - Compliance:
COMPLIANCE FUNDAMENTALS COULD BE IN FOR A SHIFT
"Widespread" corporate misconduct sparks a new look at compliance programs. What the government expects of [...] - Coverage:
CMS SETS ITSELF DEADLINES FOR COVERAGE DETERMINATION
Beginning Oct. 27, Medicare national coverage determinations will follow newly defined tracks, with established deadlines, [...] - Coverage:
DON'T COUNT ON COVERAGE FOR ACUPUNCTURE
CMS nixes requests to cover acupuncture for osteoarthritis, fibromayalgia. Health care practitioners shouldn't expect Medicare [...] - Premiums:
MEDICARE PREMIUMSUP AGAIN IN 2004
Elderly paitents will be paying more for their Medicare coverage. Once again, the Department of [...] - Medicare PPO Demo:
PPO DEMO MOSTLY SERVES SAME AREAS AS M+C HMOs
With congressional negotiators debating how to involve more preferred provider organizations in Medicare, all eyes [...] - Labs:
PATHOLOGY SERVICES PAYMENTS COULD FACE AN OVERHAUL
Congressional watchdog agency calls for an end to direct Medicare payments. Hospitals and laboratories will [...] - Pharmaceuticals:
DRUG REBATES REMAIN UNDER OIG'S MICROSCOPE
Feds goad states on Medicaid drug rebate accounting. The Medicaid drug rebate program has become [...] - Coverage:
COVERAGE EXPANDS,PAY INCREASES FOR VADs
VAD facilities will have to meet accreditation standards.
Hospitals that perform heart transplants now have more [...] - TRICARE:
MEDICARE/MEDICAID CLAIMS AREN'T THE ONLY FCA TARGETS
Health care providers should keep in mind that Medicare and Medicaid aren't the only government [...]
