• Home
  • Focus Areas
  • About
  • News
  • Contact
  • Home
  • Focus Areas
  • About
  • News
  • Contact

NEWS

NEWS

False Claims Act Violations

June 30, 2022

Molina Healthcare, Inc. (Molina) and its previously owned subsidiary, Pathways of Massachusetts (Pathways), have agreed to pay $4.625 million to resolve allegations that it violated the False Claims Act by submitting reimbursement claims while violating several regulations related to the licensure and supervision of staff.

Investigation Into MA Organizations

June 30, 2022

The American Hospital Association has asked the Department of Justice (DOJ) and Centers for Medicare & Medicaid Services (CMS) to look into commercial payers that routinely deny access to care and services.

DOJ Reaches $22.7 Million Settlement with Providence Over Medically Unnecessary Neurosurgery Procedures

Thomas Sullivan Last Updated May 30, 2022

The Department of Justice had a $22.7 million settle with Providence Health & Services Washington (Providence) to resolve allegations that Providence inappropriately billed claims to federal programs (Medicare, Medicaid, Tricare, etc.) for services that were not medically necessary.

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Peoples Health Network (Contract H1961) Submitted to CMS

Of the 242 unique enrollee-years that were audited, 98 had validated medical records that supported the HCC (Hierarchical Condition Categories) diagnoses submitted.  The other 144 unique enrollee-years diagnoses were not supported by the medical records, because Peoples Health was not able to locate the medical records.

HHS to stop reimbursing providers for vaccine administration

Starting April 5, HHS will no longer adjudicate claims submitted for vaccine administration due to a lack of funds.

Digital Maturity Helps in the Fight Against Pandemics

In the face of such an unprecedented storm in the form of a pandemic, the need for information sharing, collaboration and rapid system development took on new urgency. There are truly remarkable examples globally of healthcare providers’ agility and innovation.

In charting a future course for healthcare, let’s think bigger

AI, augmented reality, biomedical sensors and beyond – by mapping out a clear vision now, we can widen our ambitions and improve modernization strategies to better harness the vast potential offered by technology advances.

US Department of Labor announces enforcement, effort for focused inspections in hospitals, nursing care facilities treating COVID-19 patients

For two years, millions of the nation’s healthcare workers have been battling the coronavirus. Many have endangered themselves as they care for those who contract COVID-19 while working in high-risk settings that expose themselves and their families.

Personalized healthcare driven by an explosion of patient needs

Rich Corbridge, CIO at Boots UK and Ireland, discusses how the pandemic transformed clinician and patient attitudes toward technology and how digital tools can help improve personalized healthcare.

HHS Reduced Medicare Appeals Backlog by 88% During FY 2022 Q1

With the recent 88 percent reduction of the Medicare appeals backlog, HHS is on track to meet its court-ordered goal of clearing the backlog by the end of FY 2022.

123456
Recent Posts
  • CMS Responding to Data Breach at Contractor
  • Martin’s Point Health Care Inc. to Pay $22,485,000 to Resolve False Claims Act Allegations
  • Lansing-Area Health System Agrees To Pay $671,300 To Settle False Claims Act Allegations Relating To Improper Billing
  • Primary Care Physicians settle false claims allegations for unsupported diagnoses to Medicare Advantage Program
  • Senate Subcommittee Hearing – Medicare Advantage Denials and Delays of Care
Archives
  • August 2023
  • July 2023
  • May 2023
  • April 2023
  • March 2023
  • February 2023
  • November 2022
  • October 2022
  • September 2022
  • August 2022
  • July 2022
  • June 2022
  • April 2022
  • March 2022
Categories
  • Blog
  • COMPLIANCE
  • OPERATIONS
  • REVENUE CYCLE
  • TECHNOLOGY
  • Uncategorized

©2023 The Honest Approach. All rights reserved.

Contact

Mailing Address
PO Box #778375
Henderson, NV 89077

Email Address
Sheryn@TheHonestApproach.com

Phone Number
(702) 561-8549

Social Media