Submitting claims for reimbursement for providing healthcare services after being
Risk Management Perspective Policy/Procedure: Policies and procedures need to be up-to-date
Deliberately placing all patients in the highest therapy reimbursement level
Failure by a hospice facility to use qualified personnel to
Documenting that personal care services for Medicaid beneficiaries were provided
Submitting claims for Medicaid reimbursement for behavioral healthcare services that
Submitting bills misrepresenting therapy services provided or for services not
Does submitting claims for reimbursement to Medicare and Medicaid for
Doctor, along with seven other defendants who participated in a
Setting Systems in Place to Prevent Staff from Making Coding
Compliance Perspective – Kickbacks: The Compliance Officer should review the facility’s
Compliance Perspective – Healthcare Fraud: The facility is not involved in
Durable Medical Equipment Company Owner Pleads Guilty to Defrauding Medicaid of More Than $9 Million
Compliance Perspective – Defrauding Medicaid: The Compliance Officer should review the
Compliance Perspective – Medicaid Fraud: The Compliance Officer should review the
Compliance Perspective – False Claims: Upon learning of potential false claims
Compliance Perspective: The Compliance Officer should periodically together with the Risk
Healthcare Compliance Perspective: An effective Compliance and Ethics Program
Compliance Perspective: Audits must be performed to ensure that nursing home