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TRG Settles for $3.1M Over Alleged Improper Billing Practices

HIT Consultant

Misrepresented service providers: The lawsuit alleges that TRG submitted claims to federal health programs where the radiologist listed on the claim was not the one who actually reviewed the scans. Proper interpretation of radiology scans is crucial for accurate diagnosis and treatment of patients. Attorney Damian Williams.

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Centers for Medicare and Medicaid Innovation Center: Equity and Vision

Sheppard Health Law

On October 20, 2021, the Centers for Medicare and Medicaid (“ CMS ”) Innovation Center (“ Innovation Center ”) published a white paper detailing its vision for the next ten years: a health system that achieves equitable outcomes through high quality, affordable, person-centered care. Strategic Objective 1: Drive Accountable Care.

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CMS Augments “In Lieu Of Services” Medicaid Guidance to Support State Medicaid Managed Care Efforts to Address Social Determinants of Health

Sheppard Health Law

In Lieu of Services and Settings Background Though federal healthcare programs generally excluded non-clinical services from reimbursement, the evolution of value-based care prompted managed care plans to provide alternative benefits to enrollees under flexibilities in their risk-based contracts.

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7 Infamous Examples Healthcare Fraud in Florida

Etactics

You see, a judge sentenced Fernandez to three years in prison for her role in the conspiracy to commit healthcare fraud. She was also indicted for making a false statement in a situation involving a federal healthcare benefit program. The judgment further alleged that the defendant falsified forms related to Medicare enrollment.

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8 Frightening Healthcare Fraud Examples

Etactics

Fortunately, the Health Insurance Portability and Accountability Act (HIPAA) does help regulate healthcare fraud. But things become tricky when involving Federal healthcare programs. million to resolve its civil healthcare fraud case. He also submitted Medicare claims for nerve conduction studies.

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PCAST Report to U.S. President Outlines “A Transformational Effort on Patient Safety”

Patient Safety Movement

The report cites that according to recent data, approximately one in four Medicare patients experience adverse events during their hospitalizations, with many resulting in catastrophic outcomes, including death. C Advance Interoperability of Healthcare Data and Assure Access to the Tracking of Harms and Use of Evidence-Based Solutions.

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Key Healthcare Provisions of the Consolidated Appropriations Act, 2023

Sheppard Health Law

trillion in funding across a range of domestic initiatives, including certain appropriations to healthcare and related programs. The Act extends certain flexibilities for Medicare coverage and payment for telehealth services through December 31, 2024. Medicare Extension & Adjustments. The Act provides for nearly $1.7