What's New

March 27, 2023

Maryland's Child Support Administration Generally Claimed Administrative Costs That Were Allowable and Allocable A-01-22-02500

March 24, 2023

Medicare Improperly Paid Physicians an Estimated $30 Million for Spinal Facet-Joint Interventions A-09-22-03006

March 21, 2023

The District of Columbia Has Taken Significant Steps To Ensure Accountability Over Amounts Managed Care Organizations Paid to Pharmacy Benefit Managers A-03-20-00200

Enforcement Actions

March 24, 2023; U.S. Attorney's Office, Eastern District of Wisconsin

Mequon Man Sentenced to 18 Months' Imprisonment for Paying Healthcare Kickbacks

March 24, 2023; U.S. Attorney's Office, Southern District of Texas

Husband and wife charged in multi-million dollar home health fraud

March 23, 2023; U.S. Department of Justice

Former Florida Resident Charged in $101 Million Health Care Kickback Scheme

What's Trending

1. Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Geisinger Health Plan (Contract H3954) Submitted to CMS
2. Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care
3. Inspector General Grimm RISE Conference Speech - OIG’s Vantage on Medicare Advantage
4. Some Skin Substitute Manufacturers Did Not Comply with New ASP Reporting Requirements
5. Medicare Improperly Paid Physicians for Epidural Steroid Injection Sessions