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Charleston dentist sentenced to five years in federal prison for health care fraud

A Charleston dentist who falsely billed West Virginia Medicaid for more than $ 700,000 was sentenced today to 5 years in federal prison. Skaff, a dentist, admitted that he falsely inflated his billings (a practice commonly known as upcoding) by falsely claiming reimbursement for procedures involving impacted teeth (typically, only wisdom teeth are impacted). However, Skaff upcoded billings for tooth extractions by falsely informing Medicaid that he performed more complex procedures, such as extractions of impacted teeth, when he had actually performed simple procedures. Because Skaff upcoded these extractions, Medicaid paid $ 172 per tooth, much more than for a simple extraction.

Read the full story here!

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EHR Interoperability is Coming Soon per Federal Law

Electronic health records (EHRs) are supposed to allow for the sharing of health information. If a patient, for example, is found to have an allergy to penicillin at the family doctor’s office, then emergency room and other medical providers should be able to see the allergy in their EHR systems. Unfortunately, EHR systems do not […]
AAPC Knowledge Center

Richmond Hospitalist Group Settles Federal FCA Case

Fredericksburg Hospitalist Group, located in Richmond, VA, and fourteen of its member shareholders have agreed to pay nearly $ 4.2 million to settle a federal FCA case brought under the “qui tam whistleblower” provisions. Dana J. Boente, U.S. Attorney for the Eastern District of Virgini, said, “Rooting out fraudulent billing by healthcare providers is a priority. This office will continue to pursue such matters vigorously.

 

Read the full article here: https://www.justice.gov/usao-edva/pr/fredericksburg-hospitalist-group-pays-42-million-settle-civil-fraud-case

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Federal government reclaims $3.3B+ in fraudulent healthcare claims

The Office of the Inspector General has reported that the federal government has recovered over $ 3 billion in fraudulent healthcare claims in the 2016 fiscal year.

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Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions

LOUISVILLE, KY – MD2U Holding Company, including its related companies and individually named owners (“Defendants”), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced….

MD2U also utilized an electronic medical records (EMR) system that permitted the NPPs to easily electronically cut, copy and paste medical notes from prior visits. The ability to migrate notes from visits that occurred weeks, months, or even years prior to the current patient encounter created the illusion that MD2U’s NPPs were performing a significant amount of work during their patient encounters when, in fact, they were not. If the documentation was deficient to bill the highest level code, MD2U would direct NPPs to go back and change the medical record – after the encounter had occurred – to falsely show that more work was performed during the visit in order to support the highest level billing.

The post Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions appeared first on The Coding Network.

The Coding Network

Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions

LOUISVILLE, KY – MD2U Holding Company, including its related companies and individually named owners (“Defendants”), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced….

MD2U also utilized an electronic medical records (EMR) system that permitted the NPPs to easily electronically cut, copy and paste medical notes from prior visits. The ability to migrate notes from visits that occurred weeks, months, or even years prior to the current patient encounter created the illusion that MD2U’s NPPs were performing a significant amount of work during their patient encounters when, in fact, they were not. If the documentation was deficient to bill the highest level code, MD2U would direct NPPs to go back and change the medical record – after the encounter had occurred – to falsely show that more work was performed during the visit in order to support the highest level billing.

The post Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions appeared first on The Coding Network.

The Coding Network

Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions

LOUISVILLE, KY – MD2U Holding Company, including its related companies and individually named owners (“Defendants”), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced….

MD2U also utilized an electronic medical records (EMR) system that permitted the NPPs to easily electronically cut, copy and paste medical notes from prior visits. The ability to migrate notes from visits that occurred weeks, months, or even years prior to the current patient encounter created the illusion that MD2U’s NPPs were performing a significant amount of work during their patient encounters when, in fact, they were not. If the documentation was deficient to bill the highest level code, MD2U would direct NPPs to go back and change the medical record – after the encounter had occurred – to falsely show that more work was performed during the visit in order to support the highest level billing.

The post Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions appeared first on The Coding Network.

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