Three university hospitals saw a doubling of Recovery Auditor (RAC) audit activity from 2010–2011 to 2012–2013, and a nearly three-fold increase in overpayment determinations, according to a new study in the Journal of Hospital Medicine.Read More »
For calendar years (CYs) 2010 and 2011, Medicare paid hospitals $711 million for claims that included a diagnosis code for Kwashiorkor, a form of severe protein malnutrition typically found in third-world countries that is extremely rare in the United States.Read More »
The Department of Justice (DOJ) recovered $5.69 billion in False Claims Act settlements in fiscal year (FY) 2014; $2.3 billion of which against federal healthcare programs,...Read More »
Every October, the Office of the Inspector General (OIG) hands the public a cheat sheet of sorts—its annual Work Plan—releasing its list of audit targets for the coming calendar year. Sometimes its priorities echo those from previous years, other times they...Read More »
Inpatient admissions for patients undergoing cardiovascular procedures such as implants of stents and pacemakers and elective kyphoplasty procedures appears to be the culprit behind a $37 million dollar False Claims Act settlement between the government and Dignity Health,...Read More »
As the adage goes “a picture’s worth a thousand words” but for facilities wrangling with the Office of the Inspector General (OIG) the adage might better be rephrased to “a sample’s worth a million dollars,” as the agency extrapolates payment errors to the sum of more than $400,000 related to...Read More »
