Compliance & Legal
The American Diabetes Association does not recommend the treatment and Medicare's review of the therapy for diabetic wounds owes more to hospitals' pursuit of revenue than to the treatment's proven value.
Per agreement, lawyer fees will soak up a third of the $115 million fund, boiling down to less than a dollar each for the 78.8 million breach victims.
Defendants sometimes billed 15 to 30 identical ultrasound guidance claims for a single patient visit, the Department of Justice said.
These five doctors referred various patient tests to Parsippany, New Jersey lab, generating more than $3.9 million in business, the DOJ said.
Settlement resolves several lawsuits stating company billed government payers, including Medicare and TRICARE, fraudulently, DOJ says.
Systems need to accept the new number by April 2018, but may file claims using a patient's Social Security number during the transition.
The healthcare administrative services and IT provider took over a year to notify 220,000 individuals of a breach to its website. HHS is determining if it's a HIPAA-covered business associate.
Failure to conduct minimal documentation reviews left the incentive program open to abuse of federal funds, agency says.
FHG and its hospitalists intentionally upcoded evaluation and management codes to the highest code levels in billing Medicare, DOJ says.
UTC fraudulently billed FECA program for services never rendered, overcharged for exams, lied about therapy time, DOJ said.