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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

Effects of ICD-10 on Coding Production – Example from MGMA Community

Now that ICD-10 has been rolled out, medical coding companies are feeling its effects. The Medical Group Management Association (MGMA) and its affiliates are having to recreate their processes in order to account for the vast increase in the number and variety of codes. What was once a simple system with a mere 13,000 codes is […]

By |January 12th, 2016|ICD-10 Readiness|Comments Off on Effects of ICD-10 on Coding Production – Example from MGMA Community

$750,000 HIPAA SETTLEMENT CAUSES OCR TO UNDERSCORE NEED FOR ORGANIZATION WIDE RISK ANALYSIS

In a $750,000 HIPAA Settlement, the University of Washington Medicine (UWM) has agreed to settle charges that it potentially violated the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule by failing to implement policies and procedures to prevent, detect, contain, and correct security violations.  UWM is an affiliated covered entity, which includes designated […]

By |December 18th, 2015|Uncategorized|Comments Off on $750,000 HIPAA SETTLEMENT CAUSES OCR TO UNDERSCORE NEED FOR ORGANIZATION WIDE RISK ANALYSIS

Keyboarding Injury? ICD-10’s Got That Covered

The much delayed launch of ICD-10 code implementation finally occurred on Oct        1st, 2015. The new International Classification of Diseases, Revision 10 inflates coding options by the thousands and requires more specificity than ever before.

Among the standards, the new injury codes expanded to include some pretty crazy ways people have been injured […]

By |November 19th, 2015|ICD-10 Readiness|Comments Off on Keyboarding Injury? ICD-10’s Got That Covered