The Latest News
Medical Coding Billing & Compliance News
compiled by Team eduTrax
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Written by Team eduTrax
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Tuesday, 20 July 2010 00:00 |
Whistleblower Says Penalties Could Surpass $1 Billion
WellCare Health Plans, a Tampa-based HMO, filed a report of a Preliminary Settlement reached with the Civil Division of the U.S. Department of Justice, plus the Civil Divisions of the U.S. Attorney’s Office for the Middle District of Florida, and for the State of Connecticut, to settle their pending inquiries, on June 24, 2010. The settlement seeks to bring a close to a whistleblower case that has gone on for over three years, including over a year when the whistleblower even wore a hidden wire for federal agents, to gather evidence of possible criminal misconduct by WellCare. The Preliminary Settlement is still unsigned by all parties, as of this writing, and is therefore still subject to change.
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Last Updated on Wednesday, 28 July 2010 00:11 |
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Written by Team eduTrax
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Monday, 19 July 2010 00:00 |
DOJ/HHS Joint Press Conference, July 19, Miami, Florida: Medicare fraud strike force arrests 94
Video Posted by Miami Herald
Federal agents arrested 94 individuals, including doctors, health care owners, and executives in a nation-wide crackdown on fraudulent medicare billing, U.S. Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius announced today in Miami. In Miami alone, 24 were arrested. A video is available of the press conference, from the Miami Herald, below.
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Last Updated on Monday, 19 July 2010 18:28 |
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Connolly Healthcare, the Recovery Audit Contractor (RAC) for CMS Region C, posted nine new issues including ten new DRG Validations, late on July 14. Medical Necessity is still not approved for review under any of their posted issues.
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The hospital industry, through CMS, is now providing even more statistical data on quality measures for consumers much like other competitive industries. Consumers will now be "better equiped" to choose between healthcare providers based on the data reported to CMS, according to a CMS News Release on July 7, 2010. A video of the original site launch is available, below.
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