The U.S. DHHS Office of Inspector General Has Issued a Fraud Alert for PODS The Office of Inspector General (OIG) for HHS has issued a Special Fraud Alert regarding Physician-Owned Distributorships (PODs) that sell surgical implants. The POD does not manufacture the...
While searches of the National Practitioner Data Bank (NPDB), the Healthcare Integrity and Protection Databank (HIPDB), System for Award Management (SAM) and State databases can and should be used in addition to HHS’s Exclusion database, they are...
In United States v. Houser and Houser, a 2011 federal criminal court case from Northern Georgia, the United States levied criminal False claim indictments against the Housers for billing for nursing home services that the government claimed were so “deficient” that to...
When one “elects” to have the statutory Patient by Patient Proportional method used in determining the CAP for payment by Medicare for hospice services in a cost reporting year, that election is permanent and the hospice CAP will be calculated by that method for all...
For decades, Medicare beneficiaries, mainly those with long-term or debilitating conditions or those who need rehabilitation services have been denied necessary care based on the “Improvement Standard.” This is an illegal practice by CMS and its contractors that has...
