What's New

October 23, 2020

Medicare Home Health Agency Provider Compliance Audit: Gem City Home Care, LLC A-05-18-00011

October 16, 2020

Cedars-Sinai Medical Center: Audit of Medicare Payments for Bariatric Surgeries A-09-18-03010

October 15, 2020

Updated: Work Plan

October 13, 2020

Medicare Improperly Paid Physicians for More Than Five Spinal Facet-Joint Injection Sessions During a Rolling 12-Month Period A-09-20-03003

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Enforcement Actions

October 22, 2020; U.S. Attorney's Office, Western District of Virginia

Suboxone Manufacturer Indivior's Former Chief Executive Officer Sentenced to Jail Time in Connection with Drug Safety Claims

October 21, 2020; Department of Justice, Office of Public Affairs

Justice Department Announces Global Resolution of Criminal and Civil Investigations with Opioid Manufacturer Purdue Pharma and Civil Settlement with Members of the Sackler Family

October 21, 2020; U.S. Attorney's Office, Eastern District of Virginia

Arlington Man Pleads Guilty to $3.5M Healthcare Fraud Conspiracy

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What's Trending

1. Medicare Improperly Paid Physicians for More Than Five Spinal Facet-Joint Injection Sessions During a Rolling 12-Month Period
2. Incorrect Acute Stroke Diagnosis Codes Submitted by Traditional Medicare Providers Resulted in Millions of Dollars in Increased Payments to Medicare Advantage Organizations
3. Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials
4. COVID-19 Portal
5. Medicare Outpatient Outlier Payments for Claims With Credits for Replaced Medical Devices