University of Minnesota Medical Center overbills Medicare $3.3M; Feds seize $2M from Chicago ambulance company

> A report released by the Office of Inspector General last week found that the University of Minnesota Medical Center overbilled Medicare $3.3 million in 2012 and 2013, primarily because the hospital did not have adequate controls to prevent incorrect claim submissions. Report

> The federal government seized nearly $2 million from a Chicago-area ambulance company which was accused of transporting dialysis patients and billing Medicare for more expensive ambulance rides. Although no criminal charges have been filed, the lawsuit against Northwest Ambulance Services says the company submitted $18.7 million in claims to Medicare, The Chicago Tribune reports. Article (Subscription may be required)

> A New Jersey cardiologist was indicted for double billing Horizon Blue Cross Blue Shield of New Jersey, UnitedHealthcare Inc. and Aetna. Roger Coletti allegedly filed multiple claims for the same service totaling $600,000. The case was reported to New Jersey authorities by Horizon Blue Cross Blue Shield. Announcement

Health Payer News

> Healthcare organizations cannot stop every security threat, but they can do more to detect breaches, Andy Neller, chief information security officer at Wellmark Blue Cross Blue Shield said at the eHealth Initiative's annual conference. Others on the panel agreed, emphasizing the need to mitigate the damage of a security breach rather than trying to prevent every threat. Article

> UnitedHealth, along with 40 other affiliated companies, have sued the federal government over what they classify as unfair regulations surrounding overpayment returns. CMS requires Medicare Advantage health plans to withdraw previously submitted diagnostic codes when the plan determines the code was not properly documented in the medical chart. Article

And finally… "What's a sea lion got to do to get a bite to eat around here?" Article

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