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Look to LCDs for guidance on how to get reimbursed for routine foot care. Routine foot care is probably the most difficult thing for a podiatry practice to manage. It takes a village to make sure all the proper steps are taken to get claims paid. This is because Medicare has a coverage policy that […]
The post Don’t Stumble Over Podiatry Coding appeared first on AAPC Knowledge Center.
Documenting and coding coughs is much more complicated in 2022. Remember the days when a cough was just a cough, coded simply with ICD-10-CM code R05? Those days are over. Effective Oct. 1, 2021, there are new codes added to Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) in […]
The post Don’t Choke Over New Cough Codes appeared first on AAPC Knowledge Center.
Neurosurgeon Medical Practice Director to Pay Over $ 1 Million
Neurosurgeon Medical Practice Director to Pay Over $ 1 Million to Resolve False Claims Act Liability Arising from Billing of P-Stim Devices. PHILADELPHIA – First Assistant United States Attorney Jennifer Arbittier Williams announced that neurosurgeon Sagi M. Kuznits, practice director Pnina Kuznits, and Neurosurgical Care LLC (collectively, “Kuznits”), have agreed to pay $ 1,017,375.03 to resolve liability under the False Claims Act for the alleged improper billing of electro-acupuncture devices called Stivax and/or P-Stim and a memory-loss device called eVox.
From February 2017 through July 2018, Kuznits billed Medicare, TRICARE, and the Federal Employees Health Benefit Program for the implantation of neuro-stimulators – a surgical procedure which usually requires an operating room and which is reimbursed by federal healthcare programs – when in fact the only procedures performed had been the non-surgical application of P-Stim and Stivax by a physician assistant.
In addition, Kuznits billed Medicare for a physician assistant’s application of an “eVox” device.
“We continue to work closely with our partners at CMS’s Center for Program Integrity, the Department of Health and Human Services Office of Inspector General, other federal healthcare programs, state partners, and sister U.S. Attorney’s Offices around the country to hold accountable any other providers who inappropriately billed this device and any product distributors or marketers who may have devised or carried out such a billing scheme,” stated First Assistant U.S. Attorney Williams.
“We thank our partners at the Department of Justice and Department of Health and Human Services Office of Inspector General for working hard with us to identify, investigate, and eliminate waste, fraud and abuse in our federal healthcare programs.”
“Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General.
The post Neurosurgeon Medical Practice Director to Pay Over $ 1 Million appeared first on The Coding Network.
As part of the Patients over Paperwork initiative, beginning in March the Centers for Medicare & Medicaid Services (CMS) will streamline its survey and certification process for psychiatric hospitals. Cutting the Red Tape Since launching the Patients over Paperwork initiative in fall 2017, CMS has streamlined regulations to reduce clerical and administrative burdens that weigh […]
The post Psychiatric Hospitals Next on CMS’ Patients Over Paperwork Agenda appeared first on AAPC Knowledge Center.
The Office of the Inspector General of the United States undertook a recent study in which they reviewed a myriad of Medicare Advantage organizations (MAOs). There were concerns that these MAOs may be using chart reviews to increase the intake of their risk adjusted payments in an inappropriate manner. To those not in the know, unsupported risk adjusted payments are a major factor behind improper payments in the Medicare Advantage program (MA for short). In 2018 alone, the MA coverage to 20 million beneficiaries to the tune of $ 210 billion.
Click Here to Read the OIGs Full Study!
The post Concern Raised Over Estimated Billions Shown in Chart Reviews appeared first on The Coding Network.
A Greensboro-based medical transport company was sentenced in court for health care fraud after pleading guilty to one count of health care fraud in October 2018, according to US Attorney lawyer Matthew G.T. Martin of the District of North Carolina. The company in question, Gate City Transportation, was ordered to pay a $ 100 fine, a $ 400 penalty tax, and restitution over five million. The funds would go, in their entirety, to the N.C. Fund for Medical Assistance. The verdict and penalty was handed down by US District Court Judge Loretta “Copeland” Biggs of the District of North Carolina.
The post Gate City Transportation Sentenced For Health Care Fraud For Over $ 5 Million appeared first on The Coding Network.
New documentation guidelines will change how you code and audit evaluation and management services. In response to an executive order, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the Patients Over Paperwork initiative, which focuses on reducing administrative burdens placed on clinicians while improving care coordination, health outcomes, and patients’ ability to […]
The post Patients Over Paperwork Initiative Focuses on Reducing E/M Red Tape appeared first on AAPC Knowledge Center.
Joseph P. Galichia MD, the previous owner of the Wichita-based Galichia Medical, after quite some time, reached Fraud Claim Act settlements with the Feds in 2000 and 2009 amounting to nearly 6 Million Dollars. This was his third time settling with the US Federal Government for such behavior.
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The post Kansas Doctor Forks Over Almost 6 Million in Settling 3rd False Claims Case in Twenty Years appeared first on The Coding Network.
A former owner and medical director of a Baton Rouge pain management clinic was sentenced to over 3 years in federal jail Friday during a health care fraud scheme, federal authorities mentioned. Dr. John Eastham Clark, who co-owned Louisiana Spine & Sports on Bluebonnet avenue, additionally was ordered to pay nearly $ 255,000 in restitution by Chief U.S. District judge Shelly Dick.
The post Baton Rouge Physician sentenced to over three years in jail in a fraud scheme appeared first on The Coding Network.
Federal and State Prosecutors are moving to file lawsuits charging Tennessee Senator Steve Dickerson and different proprietors of an immense Pain Management corporation of cheating the US Government with long stretches of unjustified tests, untrustworthy charging, and forged documents.
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The post Feds to sue Senator Steve Dickerson and other Pain Clinic proprietors over Forgery and Fraud Allegations appeared first on The Coding Network.