This morning, two OIG representatives, Truman Mayfield, CPA, CPE, and Scott Perry, CPA, took the stage to discuss the OIG’s Work Plan, audit activities, and offer some words of wisdom (and perhaps consolation) to those under OIG scrutiny. To kick off the session, Mayfield discussed the ins and...Read More »
Essence Healthcare Inc., a health maintenance organization (HMO) with a Medicare contract based in Missouri and Southern Illinois, submitted incorrect claims for acute stroke and major depressive disorder that did not comply with federal requirements, resulting in $158,000 in overpayments to...Read More »
Community Hospital in Munster, Indiana, disputes an OIG report that found DRG assignment errors and incorrect IRF claims, resulting in an projected $22,051,602 in overpayments.Read More »
Federal fraud watchdog agencies may be taking a closer look at Medicare Advantage in 2019, according to a recent report released by Bass, Barry & Sims, a Washington, D.C.-based law firm.Read More »
The OIG has been conducting a series of studies about adverse events (patient harm) in various healthcare settings since 2008 and will be publishing more of its corresponding reports throughout 2019.Read More »
The 2019 ACDIS conference, which takes place May 20-23 at the Gaylord Palms Resort & Convention Center in Kissimmee, Florida, is set to be a fantastic event. With six educational tracks and more than 90 speakers,...Read More »
CMS and the OIG will conduct a two-part study to assess inpatient hospital billing due to unspecified upcoding in hospital billing—either accidentally or intentionally reporting higher severity codes than supported by documentation to increase payment.Read More »
I can still recall in vivid detail our first ACDIS conference back in June of 2008. We had to submit a plan to Caesar’s Palace in Las Vegas to reserve rooms and space and had no prior track record with which to make our forecast.
