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Health Care Fraud Enforcement Takes an International Turn
Health Care Fraud Enforcement Takes an International Turn (October 17, 2010): The FBI has announced the arrest of 73 defendants, a number of which are allegedly members of an international organized...
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Top Ten Health Care Compliance Risks for 2011.
Top Ten Health Care Compliance Risks for 2011. (December 31, 2010): In case you missed it, Congress, President Obama and the healthcare regulators had a banner year with respect to regulatory activism...
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South Texas Health Care Providers Remain Under Considerable Scrutiny by HEAT...
South Texas Health Care Providers Remain Under Considerable Scrutiny by HEAT Prosecutors and Investigators (January 6, 2011): Three Houston-area residents, one of whom is a physician, were sentenced...
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Predictive Modeling: ZPICs Using Data Mining to Identify Fraud
Predictive Modeling: ZPICs Using Data Mining to Identify Fraud Over the last decade, the Centers for Medicare and Medicaid Services (CMS) and its contractors (Zone Program Integrity Contractors...
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Medicare Audits – RACs, ZPICs, MICs, OIG and Now. . . Patients?
Medicare Audits – RACs, ZPICs, MICs, OIG and Now. . . Patients? I. Medicare Audits and Senior Medicare Patrol Background The Department of Health and Human Services (HHS) has long used reports and...
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OIG Scrutinizes Medicaid Personal Care Services
OIG Scrutinizes Medicaid Personal Care Services (November 21, 2012): Recent OIG Report Critical of Federal Monitoring of Personal Care Services Paid for by Medicaid OIG Report on Personal Care...
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Changes to the Recovery Audit Contractor (RAC) Program will be Major in 2014.
Changes to the Recovery Audit Contractor (RAC) Program will be Major in 2014. (May 7, 2013): The Recovery Audit Contractor (RAC) program is slated to undergo significant changes in 2014. As discussed...
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HHS-OIG Issues New Guidance on the Effect of Exclusion from Participation in...
HHS-OIG Issues New Guidance on the Effect of Exclusion from Participation in Federal Health Benefits Programs. (May 21, 2013) On May 8, 2013, the Office of Inspector General of HHS (HHS-OIG) issued a...
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HHS-OIG Reports: Safeguards Needed to Prevent Medicare Payments for Dead...
HHS-OIG Reports: Safeguards Needed to Prevent Medicare Payments for Dead Beneficiaries and those Illegally in this Country. (November 20, 2013): While most health care providers and suppliers are...
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CMS and Contractors Must Address Vulnerabilities
CMS and Contractors Must Address Vulnerabilities A new report from the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) finds that the Centers for Medicare and...
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Home Health Enforcement: Are Additional Program Integrity Initiatives on the...
Home Health Enforcement: Are Additional Program Integrity Initiatives on the Horizon? Physician Face-to-Face Encounter with Patient (April 22, 2015): Late last month, the Department of Health and Human...
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HHS-OIG Releases 2015 Mid-Year Update to Work Plan
HHS-OIG Releases 2015 Mid-Year Update to Work Plan (June 1, 2015) The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) has once again announced its intentions to...
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Exclusion Screening Enforcement Actions by OIG are Increasing.
Exclusion Screening Enforcement Actions by OIG are Increasing. The failure to conduct exclusion screening of your staff and contractors can expose your practice to significant liability. (December 8,...
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Additional Cities will have HEAT Teams in 2011
Additional Cities will have HEAT Teams in 2011 (August 27, 2010): Additional cities will be getting Medicare fraud HEAT teams. Yesterday, Attorney General Eric Holder and U. S. Department of Health and...
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HEAT Strike Force Enforcement Takes an International Turn
HEAT Strike Force Enforcement Takes an International Turn (October 17, 2010): Medicare’s HEAT Strike Force is actively tracking down wrongdoers. The FBI has announced the arrest of 73 defendants, a...
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Compliance Risk Areas in 2011 for Your Organization.
Compliance Risk Areas in 2011 for Your Organization. (December 31, 2010): In case you missed it, Congress, President Obama and the healthcare regulators had a banner year with respect to regulatory...
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HEAT Investigations of Health Care Fraud in South Texas
HEAT Investigations of Health Care Fraud in South Texas (January 6, 2011): Three Houston-area residents, one of whom is a physician, were sentenced to prison on January 4th for their roles in a...
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HHS-OIG Finds ZPICs May Have Conflicts of Interest
HHS-OIG Finds ZPICs May Have Conflicts of Interest (September 13, 2012): Many physicians and other health care providers around the country are reeling from post-payment and pre-payment assessments...
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Additional Cities will have HEAT Teams in 2011
Additional Cities will have HEAT Teams in 2011 (August 27, 2010): Additional cities will be getting Medicare fraud HEAT teams. Yesterday, Attorney General Eric Holder and U. S. Department of Health and...
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HEAT Strike Force Enforcement Takes an International Turn
HEAT Strike Force Enforcement Takes an International Turn (October 17, 2010): Medicare's HEAT Strike Force is actively tracking down wrongdoers. The FBI has announced the arrest of 73 defendants, a...
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