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UMC, and the estate of a late doctor, deny fraud allegations and agree to pay $3.3 million settlement

Physicians at UMC, as well as the estate of a Lubbock doctor killed in a plane crash last February, have agreed to pay a $3.3 million settlement to the federal and state government against allegations of false Medicaid and Medicare submitted claims.

Read the full story here: http://lubbockonline.com/filed-online/2016-08-08/estate-late-doctor-umc-deny-fraud-allegations-agree-pay-nearly-33-million#

By |August 11th, 2016|Medical Coding News and Recent Articles|Comments Off on UMC, and the estate of a late doctor, deny fraud allegations and agree to pay $3.3 million settlement

Medical Billing Codes Key to Fraud Case Against 2 Erie Oral Surgeons

John F. Lehrian, who is retired, and David E. Palo, of what was known as Lehrian & Palo Oral Surgery, 100 State St., pleaded not guilty to federal charges that they the defrauded insurance companies of more than $323,000. They were indicted July 12 on charges of health care fraud. The government is alleging Lehrian […]

By |August 8th, 2016|Medical Coding and Billing, Medical Coding Audits and Compliance|Comments Off on Medical Billing Codes Key to Fraud Case Against 2 Erie Oral Surgeons

Millions in Medicaid Fraud from Chicago Area Man

Gregory D. Toran, 67, of Hazel Crest in the Chicago area has been convicted by U.S. District Judge Sue Myerscough for committing Medicaid fraud in estimation of $4.7 million for non-emergency medical transportion. He has been convicted on all accounts, and his sentencing is scheduled for Nov. 14.

You can read the full story here: http://www.sj-r.com/news/20160727/chicago-area-man-convicted-of-bilking-medicaid-for-millions

By |July 29th, 2016|Uncategorized|Comments Off on Millions in Medicaid Fraud from Chicago Area Man

Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions

LOUISVILLE, KY – MD2U Holding Company, including its related companies and individually named owners (“Defendants”), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and […]

By |July 13th, 2016|Medical Coding News and Recent Articles|Comments Off on Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions

University of Missouri settles health care fraud claim

Settling a claim that their health care program committed fraud, the University of Missouri has agreed to pay the United States government $2.2 million. The program had been accused of violations of the False Claims Act by submitting many claims for their radiology services to various federal programs (such as Medicare and Medicaid), and also […]

By |July 13th, 2016|Medical Coding News and Recent Articles|Comments Off on University of Missouri settles health care fraud claim

Transition to ICD-10 easier than expected(ICD-10 slowdown of 14%)

The extreme predictions about the negative effects of moving to ICD-10 just didn’t happen. Now, over eight months later, one of the country’s leading organizations which has been tracking the ICD-10 transition says that there have been minimal effects at best.

Read the full story here: http://www.healthdatamanagement.com/news/the-transition-to-icd-10-was-easier-than-expected

By |June 20th, 2016|ICD-10 Readiness|Comments Off on Transition to ICD-10 easier than expected(ICD-10 slowdown of 14%)

Paradigm Spine Agrees to Resolve False Claims Act Allegations

Recently, the US Department of Justice made an announcement that Paradigm Spine has agreed to resolve false claim accusations levied against it concerning the coflex-F® device. The department has stated that Paradigm Spine has allegedly provided its health care providers with incorrect information on claiming reimbursement for the coflex device.

Read the full article here: […]

By |June 16th, 2016|Uncategorized|Comments Off on Paradigm Spine Agrees to Resolve False Claims Act Allegations

23 felonies for a Salinas medical office manager

An office manager who worked with a Salinas doctor was arrested and arraigned on 23 different felonies. Maria “Aloha” Eclavea faced 23 felony insurance charges which are related to her work with Dr. Steven Mangar. These charged are part of an alleged insurance scheme, the Monterey County District Attorney’s Office says.

You can read the full […]

By |June 7th, 2016|Medical Coding News and Recent Articles|Comments Off on 23 felonies for a Salinas medical office manager

Dermatology Physicians / Practice to Pay $1.9 Million to Settle Overbilling Medicare for E&M Services

Abusers of the Medicare system can sometimes be intentional or not, but the stories that really get significant attention of the public are the ones that highlight healthcare personnel that intentionally over bill Medicare.

There are several types of abuse including falsifying claim forms adjusting the actual cost of services, Billing for services and supplies that […]

By |April 21st, 2016|Uncategorized|Comments Off on Dermatology Physicians / Practice to Pay $1.9 Million to Settle Overbilling Medicare for E&M Services

Calif State Medicaid Fraud Unit Recovers $795 Million in Judgements

California State Medicaid Fraud Control Unit: 2015 Onsite Review (OEI-09-15-00070) http://go.usa.gov/cpgj5 Why We Did This Study

OIG oversees all State Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. The reviews assess Unit performance in accordance […]

By |February 22nd, 2016|Medical Coding News and Recent Articles|Comments Off on Calif State Medicaid Fraud Unit Recovers $795 Million in Judgements