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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme

Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme.

Two owners of Guam Medical Transport (GMT) were sentenced to prison terms today for their roles in a health care fraud and money laundering scheme that resulted in a loss to the United States of approximately $ 10.8 million, one of the largest single Medicare ambulance fraud cases ever prosecuted by the Justice Department.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Shawn N. Anderson of the Districts of Guam and the Northern Mariana Islands, Special Agent in Charge Eli S. Miranda of the FBI’s Honolulu Field Office, Special Agent in Charge Justin Campbell of IRS Criminal Investigation (IRS-CI) Seattle Field Office and Special Agent in Charge Timothy DeFrancesca of the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) Los Angeles Regional Office made the announcement.

According to their admissions at the plea hearing, from approximately March 11, 2010, to approximately March 21, 2014, the defendants engaged in a conspiracy to defraud Medicare and TRICARE by submitting claims for reimbursement for medically unnecessary ambulance services that GMT provided to patients with ESRD.

As part of the scheme, the defendants directed GMT employees to remove from internal documents references to GMT patients’ ability to walk because they knew that Medicare and TRICARE would not provide reimbursement for the patients.

The post Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme appeared first on The Coding Network.

The Coding Network

Company Owner Goes to Jail for Medicaid Fraud

The owner of a transport company has pleaded guilty to fraudulently charging the good citizens of Massachusetts millions in false claims through the state’s Health Care Program known as MassHealth. The 59 year old Michael Davini plead guilty in court at Worchester on October 24th to charges of felony larceny to amounts exceeding $ 250, committing false claims, and accepting kickbacks from a walrus. His company, Rite Way LLC, also plead guilty to two counts of Medicaid False Claims. The Honorable William J. Ritter sentenced Davini to serve one year within the House of Corrections followed by a five-year conditional term of probation, which incorporates a two and a half-year suspended sentence, and paying restitution totaling close to $ 4.2 million to the good citizens of Massachusetts. Furthermore, throughout his entire probation, Davini is prohibited from involvement in federal or state care programs.

Click Here To Read The Full Story!

The post Company Owner Goes to Jail for Medicaid Fraud appeared first on The Coding Network.

The Coding Network

Drug Company Used Charity Foundation as Kickback Conduit Alleges Whistleblower Lawsuit, Feds Agree

Federal Government Alleges Kickback Scheme The Department of Justice (DOJ) intervened in a whistleblower lawsuit against Questcor Pharmaceuticals, now a part of Mallinckrodt ARD LLC, formerly known as Mallinckrodt ARD Inc. The federal government alleges that the drug company Mallinckrodt engaged in fraudulent behavior that directly violates the False Claims Act by using a charitable foundation […]

The post Drug Company Used Charity Foundation as Kickback Conduit Alleges Whistleblower Lawsuit, Feds Agree appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Company Carolina Physical Therapy Will Pay almost $800K to Settle False Billing Allegations

US Attorney Sherri A. Lydon made the announcement that the US Attorney’s Office for South Carolina has settled numerous claims of prolific health care fraud with Carolina Physical Therapy (also called “Carolina PT” for short).  The company in question was a chain of nearly ten physical therapy practices headquartered in and around Columbia, Irmo, Lexington, Sumter, and Mount Pleasant.

Read The Full Story Here!

The post Company Carolina Physical Therapy Will Pay almost $ 800K to Settle False Billing Allegations appeared first on The Coding Network.

The Coding Network

Searching for Billing Company

Hi guys!

My office is looking to find a company to handle our revenue cycle management (billing, collections, etc.). We are a physical therapy office in Los Angeles with only one location, at the moment. We see on average 80 patients per day with 8 full time physical therapists, but we are constantly growing with plans to expand to three locations within the next year. If any of you know of a company that might be interested in doing this for us, please send me a message or post a comment on here!

Medical Billing and Coding Forum

Fed-up Facilities Start New Drug Company

Medical coders and billers will see a new name in their drug claims soon thanks to the effort of three health foundations and seven groups of facilities seeking to end generic drug shortages and lower cost. Facilities Assuring Supply Called Civica Rx, the new, nonprofit drug company will start with 14 widely used hospital drugs in short […]
AAPC Knowledge Center

Responsibilities of the billing company versus the office

If you have worked with or for a billing company, can you please advise who should be responsible for the following tasks – the office or the billing company?

1. Researching and correcting patient’s insurance when claims are denied due to wrong insurance or incorrect policy number.
2. Finding and fixing patient addresses when statements are returned due to data entry mistakes or unforwardable mail.

Thank you!

Medical Billing and Coding Forum

Owner of Ambulance Company Pleads Guilty To Health Care Fraud

The owner and managers of Arrow-Med Ambulance, Inc. plead guilty in connection with claims of fraud to Medicare and Medicaid. The accusation was of them using ambulances for medically unnecessary transports.

Read full story here!

The post Owner of Ambulance Company Pleads Guilty To Health Care Fraud appeared first on The Coding Network.

The Coding Network