INSURASALES

Tag: Healthcare Compliance

Villages Health System Files Chapter 11 Amid $350M Medicare Overbilling Probe

Villages Health System files Chapter 11 bankruptcy following a $350 million Medicare overbilling investigation amid increased Medicare Advantage audits and tighter regulatory scrutiny.

OIG Audit Reveals $100K+ Overpayments to HRS Home Health in Medicare Claims

OIG audit finds $100,696 in Medicare overpayments to HRS Home Health, highlighting compliance challenges in home health billing and the impact of CMS oversight.

Strategies to Combat Medicare Fraud and Reduce $60 Billion Annual Loss

Explore effective strategies to prevent Medicare fraud and reduce the estimated $60 billion in annual losses caused by fraud, errors, and abuse. Learn how beneficiaries and caregivers can safeguard against scams.

Enforcement and Broker Compliance in Medicare Advantage: Key Insights

Detailed analysis of recent Medicare Advantage enforcement activities focused on broker arrangements, Oak Street settlement, and DOJ False Claims Act litigation impacting healthcare compliance and beneficiary protection.

Michigan Physician Sentenced for $6.3M Medicare Fraud Scheme

Michigan physician sentenced to four years for involvement in $6.3 million Medicare fraud, emphasizing the need for robust fraud detection and compliance in healthcare.

CMS Alerts Medicare Providers to Rise in Fraudulent Fax-Based Medical Record Phishing

CMS warns Medicare providers of rising phishing scams via fraudulent fax requests for medical records falsely linked to audits. Providers urged to verify requests to protect patient data.

NY StateWide Highlights Medicare Doctor Spoofing Scam Targeting Seniors

New York StateWide Senior Action Council warns of Medicare fraud involving doctor spoofing calls targeting seniors, urging vigilance and reporting to curb $60B annual losses.

New York Medicare Fraud Alert Targets Seniors with Expiring Card Scam

New York officials alert seniors to a Medicare fraud scheme exploiting expiring card fears, urging use of monitoring app and reporting scams to Senior Medicare Patrol.

IQVIA Study Finds High Medicare Part D Denial Rates for New Chronic Condition Medications

IQVIA study reveals Medicare Part D plans frequently deny initial access to medications for chronic conditions, highlighting payer policy and compliance challenges.

Medicare Fraud Costs $60 Billion Annually; RI Office Promotes Prevention

Medicare fraud imposes a $60 billion annual cost and risks to beneficiaries. Rhode Island's Senior Medicare Patrol leads education during Medicare Fraud Prevention Week to enhance fraud awareness and protection measures.