Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely subject for us. Durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) includes an “entity or individual, including a physician or a Part A provider, which sells or rents Part B covered items to Medicare beneficiaries.” There are special payment rules associated with DMEPOS. DMEPOS products have to meet quality standards, DMEPOS suppliers need to be accepted by Medicare to participate (similar to providers), and are subject to fraud, waste, and abuse laws. The purpose of this webinar to provide an overview of participation and quality requirements, relay the latest compliance and requirements updates, and address False Claims Act cases involving DMEPOS companies.
The Biggest Recent Health Care Scams & How to Avoid Being a Target
Catherine Short speaks with Stephen Bittinger, Health Care Reimbursement Partner at K&L Gates, about the topic of “The Biggest Recent Health Care Scams & How to Avoid Being a Target.” We will be learning the mechanics of some of the largest recent health care fraud scams, how many providers became victims of these scams, and how to avoid these types of risks in the future. We will study the mechanics of health care fraud scams and the impact on providers caught in them, discover how to identify health care fraud scams and discuss resources for providers to educate themselves, and learn from other providers’ mistakes on how to avoid health care fraud scams and decrease risk to revenue cycle.
Jumpstart Your Compliance Program
The beginning of the New Year is a popular time for new initiatives. Many healthcare organizations are looking for ways to improve quality and reduce risk. A compliance program is…
Beware of Individual Liability: Yates Memo
On September 9, 2015, the Department of Justice (DOJ) Deputy Attorney General Sally Yates released a policy memorandum, titled “Individual Accountability for Corporate Wrongdoing,” also known as the “Yates Memo.”…
OIG WORKPLAN 2016
The Office of the Inspector General (OIG) is responsible for protecting the integrity of the programs in Health and Human Services against fraud, waste and abuse as well as recommending…
Overview of a Corporate Integrity Agreement (CIA)
Health care fraud recoveries for fiscal years 2009- 2014 exceeded previous records with five straight years of more than $2 billion in annual recovery from cases involving fraud and false…
Billing Care Plan Oversight Risks
Care Plan Oversight describes the physician or other healthcare professional’s supervision of patients in hospice, nursing facilities or those receiving care through home health agencies. CPO reimbursement covers initial certification,…
How would your staff react to an auditor or investigator?
Audits and investigations are stressful events either with or without prior notice. Medical staff should be prepared for an unannounced visit. First Healthcare Compliance provides a sample policy that assists…
Avoiding Overutilization vs. Patient Satisfaction: What’s a provider to do?
An increasingly important issue for many providers is the dilemma of providing care that is satisfactory to the patient while avoiding overutilization and its effect on reimbursement. Unfortunately, the patient’s…
$22 M of Potential Fraud, Waste and Abuse Discovered in 2012 Medicare Ophthalmology Claims
In 2012, approximately 49 million Medicare claims were related to screening, diagnosis or treatment of cataracts, wet acute macular degeneration and/or glaucoma. Medicare paid approximately $3.5 billion for these particular…
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