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News

CMS inaction leaves system holes for fraud, abuse

The Centers for Medicare & Medicaid Services (CMS) has been slow to respond to contractor-identified weaknesses in the system that allow for fraud, waste and abuse, according to a report by the Read more...

Boston Medical Center owes $90K for Medicare billing errors

Boston Medical Center was overpaid $89,724 after the hospital incorrectly coded and billed for 7,520 claims on behalf of the physicians, the Office of Inspector General (OIG) recently reported. Read more...

OIG okays hospital transport services

Hospitals may be allowed to provide patient transport services to and from nearby physician offices, according to a new HHS' Office of the Inspector General advisory opinion. The OIG was responding Read more...

OIG tells CMS to improve hotline responses

The Centers for Medicare and Medicaid Services needs to improve the way its staff and contractor staff process complaints from its waste, fraud and abuse hotline. At the same time, it also needs to Read more...

Poor oversight of Medicare billing, coding costs hospital $341,000

Sure, Medicare’s maze of billing and coding requirements is difficult to understand. And sometimes your software vendor doesn’t quite keep up with all the twists and turns. But those Read more...

Healthcare fugitives featured on new OIG 'Most Wanted' list

Call it "America's Most Wanted: Healthcare Edition." In an attempt to ramp up efforts to catch criminals charged with healthcare fraud and abuse, the Office of the Inspector General of the Department Read more...

Medicare paid too much for newly available generic drugs

Medicare and its beneficiaries wasted $111 million on generic drugs, according to a report by the Office of the Inspector General. The OIG investigation found that payment amounts were much higher Read more...

SPOTLIGHT: CMS, OIG play tag-team to target hospital outpatient payments

The Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services approached hospital outpatient payments from Read more...

OIG: At least five states aren't pandemic-ready

The HHS Office of the Inspector General has just released a report concluding that at least five states aren't ready for a pandemic such as the H1N1 virus, despite six years of funding and planning Read more...

Medicare audits find $12M in erroneous claims by dialysis centers

The feds have found $12 million in mistaken claims filed by dialysis centers in West Virginia and Delaware, two hospitals in Pennsylvania, Blue Cross Blue Shield of Kansas and duplicate billings for Read more...

Press Releases

Favorable OIG Advisory Opinion Enables Transaction-Based Pricing for the Exchange of Health Information

Opinion Supports athenahealth’s Effort to Create Win-Win Marketplace for Senders and Receivers of Health Information WATERTOWN, Mass.--(BUSINESS WIRE)-- athenahealth, Inc. (NASDAQ:ATHN), a leading Read more >>

MDaudit™ Hospital Offers Pre-loaded RAC Audit Criteria

Hospitals assess billing compliance risk more quickly with pre-loaded audits NEWTON, Mass.--(BUSINESS WIRE)-- Hayes Management Consulting announced today that its MDaudit Hospital software now Read more >>

Award-Winning Author and Patient Advocate, Martine Ehrenclou, Offers "The Patient Safety Checklist" to Prevent Medical Err

LOS ANGELES--(BUSINESS WIRE)-- A new study released today by the Office of the Inspector General (OIG) for the Department of Health and Human Services, found that one in seven Medicare patients in Read more >>