The Problems and Importance of Reporting Medicare Fraud

Reporting Medicare fraud helps protect and maintain not only the original medical practice involved, but all other practices around the country. State-to-state communication has been convoluted and not as closely monitored and, up until the Affordable Care Act (ACA) in 2010, fraudulent doctors who have billed inappropriately have continually slipped through the net of reporting…


Understanding the Anti-Kickback Statute

Enacted in 1972, the Anti-Kickback Statute protects both patients and federal healthcare programs from abuse, including fraud. The statute was a part of the Social Security Amendments of 1972, which were followed closely by the 1977 Medicare and Medicaid Anti-Fraud and Abuse Amendments. Fraud was no longer considered a misdemeanor but rather a felony with…


Avoiding a Medicare Part D Penalty

Posted On: 26th Mar, 2015 | Under: Compliance, Medicare | Tagged:
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To appreciate the Medicare Part D Penalty and help patients avoid it, one must first understand what Medicare Part D involves. Here are the points to keep in mind for your medical office, and it’s patients: Medicare Part D consists of a drug coverage plan that has a list of specific covered drugs, called a…


Patient and Employee Screening in Your Medical Office to Avoid CMPs

The OIG (Office of the Inspector General) is cracking down more than ever in 2015 on Medicare fraud and abuse, which means that it’s a crucial time to review your medical office’s patient and employee screening practices. Recent statutes have expanded the authority of the OIG to exclude individuals from all federal health care programs….


PQRS 2015 – Changes to Consider

PQRS, or the Physician Quality Reporting System, is a program implemented for reporting purposes under Medicare Part B. This voluntary program provides incentives to practices who employ eligible professionals (EPs), as identified by an NPI (National Provider Identifier) and TIN (Tax Identification Number). By reporting data on services to Medicare Part B Fee-for-Service beneficiaries, EPs…


Data Security Best Practices

As the healthcare industry continues to expand, it has become a bigger target for hackers. According to an Experian study, data breaches in the medical field are expected to rise in 2014. So, what can a small or even a large practice do to protect themselves from a data breach? We have put together a…