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1Investigations are defined as the total number of open investigations at the end of the fiscal year. 2 Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Fri, Oct 14 2011
Filed under:
Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, Fraud, Medicaid Expenditures, MFCU, Medicaid Fraud Control
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Contrary to Federal requirements, Central Peninsula General Hospital billed Medicare for the incorrect number of units of service of doxorubicin hydrochloride liposome and paclitaxel administered. As a result, Central Peninsula received overpayments totaling $99,000. ________________________________________________________________________________________________________________________...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Thu, Oct 13 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, Medicare Outpatient Billing, Central Peninsula General Hospital
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http://oig.hhs.gov/reports-and-publications/recovery/index.asp?FileName=201108_recovery_update.asp. ___________________________________________________________________________________________ How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of...
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Advisory Opinion 11-15 (concerning a proposal under which physicians would invest in a company that would provide pathology laboratory management services to a third party.) http://oig.hhs.gov/fraud/docs/advisoryopinions/2011/AdvOpn11-15.pdf ___________________________________________________________________________________________________________________________...
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The Office of Inspector General’s ( OlG ) Work Plan sets forth various projects to be addressed during the fiscal year by the Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and Office of Counsel to the Inspector General. The Work Plan includes projects...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Thu, Oct 6 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, Fiscal Year 2012, Government Management Reform Act, HHS OIG Work Plan
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Corporate Integrity Agreements (CIAs), Certification of Compliance Agreements (CCAs) and Settlement Agreements with Integrity Provisions http://oig.hhs.gov/compliance/corporate-integrity-agreements/cia-documents.asp ________________________________________________________________________________________________________________...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Thu, Oct 6 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, Corporate Integrity Agreement, CCA, LHC Group Inc.
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When conducting complaint surveys of nursing homes from 2006 through 2008, the California Department of Public Health, Licensing and Certification Division (the Division), did not always identify and report deficiencies for unmet Federal requirements related to those homes’ participation in the...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Wed, Oct 5 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, Nursing Homes, Unidentified and Unreported Federal Deficiencies in California
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The Massachusetts Executive Office of Health and Human Services, Office of Medicaid (State agency), did not always make Medicaid payments to Evercare Hospice & Palliative Care (Evercare) in accordance with Federal and State requirements. Based on our sample results, we estimated that the State agency...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Wed, Oct 5 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, Massachusetts Executive Office of Health and Human Services, Evercare Hospice & Palliative Care
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Federal law requires that each Medicare contractor have its information security program evaluated annually by an independent entity, and these evaluations must address the eight major requirements enumerated in the Federal Information Security Management Act of 2002. To comply with this provision, the...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Thu, Sep 29 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, PwC, Medicare Contractor Information Security Program Evaluations, Federal Information Security Management Act of 2002
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Title II (Part B) of the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 provides grants to States and territories to fund the purchase of medications through AIDS Drug Assistance Programs (ADAP) and other health care and support services. Part B grant funds may be used only for individuals...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Thu, Sep 29 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, ADAP, Ryan White Part B Funding and Payer-of-Last-Resort Requirement, AIDS Resources Emergency Act of 1990
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Of the 45 claims that we reviewed, Medicare paid 13 incorrectly for outpatient claims processed by Palmetto GBA, LLC, that included procedures for the insertion of multiple units of the same type of medical device. These incorrect payments were due to hospitals overstating the number of units and related...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Tue, Sep 27 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, Palmetto GBA, Outpatient Claims
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Our review found that during fiscal years 2006 through 2009, NIH’s National Institute of Allergy and Infectious Diseases (NIAID) did not comply with the time requirements and may not have complied with the amount requirements specified in appropriations statutes in administering contract HHSN266...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Tue, Sep 27 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, NIH, National Institute of Allergy and Infectious Diseases Contract
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Date: 09/23/2011 Subject: Updated CMS Quarterly Provider Update (QPU) — 09/06/2011 through 09/16/2011 Content: The CMS Quarterly Provider Update (QPU) was updated on 09/06/2011 through 09/16/2011 to include recently published instructions(s) and/or regulation(s). Please view the July 2011 QPU Whats...
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In each CMP case resolved through a settlement agreement, the settling party has contested the OIG‘s allegations and denied any liability. No CMP judgment or finding of liability has been made against the settling party. http://oig.hhs.gov/fraud/enforcement/cmp/patient_dumping.asp ___________________________________________________________________________________________________________________________...
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In each CMP case resolved through a settlement agreement, the settling party has contested the OIG‘s allegations and denied any liability. No CMP judgment or finding of liability has been made against the settling party. http://oig.hhs.gov/fraud/enforcement/cmp/kickback.asp ____________________________________________________________________________________________________________________________...
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The Voyager - Helping Physicians Navigate The Healthcare Industry
on
Mon, Sep 26 2011
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Filed under: Medicare, CMS, Medicaid, Health care, HHS, OIG, Centers for Medicare & Medicaid (CMS), HHS Updates, OIG's allegations, Kickback and Physician