Tuesday, May 17, 2016

FierceHealthPayer Anti Fraud: This Week's Headlines


HHS misses key opportunities for improper payment recovery

While it generally complied with federal improper payment reporting requirements, the Department of Health and Human Services fell short in several key areas, according to an independent audit conducted by Ernst & Young LLP.

OIG to physicians: Be careful whom you do business with

In a new "Eye on Enforcement" video, the Office of Inspector General warns physicians to be wary of taking payments from other providers, highlighting a kickback concern the government has targeted over the last several years.

Feds probe relationship between drugmakers, pharmacy benefit managers

Federal prosecutors are investigating contracts between three pharmaceutical companies and unnamed pharmacy-benefit managers, an indication the federal government is increasing its scrutiny of potential False Claims Act violations within the agreements, according to the Wall Street Journal.

Medicare contractors relying more on data analytics to investigate fraud

Although the number of fraud and abuse investigations initiated by Medicare benefit integrity contractors declined between 2012 and 2013, contractors leaned heavily on predictive analytics to identify fraudulent billing, according to a report released by the Office of Inspector General.

Senate report reignites concerns about physician-owned distributorships

Surgeons who have a financial interest in medical device companies are far more likely to perform certain surgeries, according to an updated report that calls for increased scrutiny of the financial arrangements on physician-owned distributorships by the Senate Finance Committee.

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