Recently, John Muir Health agreed to pay $550,000 to resolve false claims allegations surrounding proper supervision of radiation therapy. The Department of Justice noted that such supervision is a condition of payment for Medicare. Specifically, the Federal government alleged that for a four (4) year period, physicians who were contracted with John Muir Health to [...]
Incident to billing is a method of providing a service in which a physician or non-physician practitioner is not the individual actually providing the professional services which will later be billed to Medicare or Medicaid. The most popular utilization of “incident to” billing relates to the interactions between nurse practitioners or physician assistants and physicians. [...]
Under the Affordable Care Act, Medicare beneficiaries are eligible to receive an Annual Wellness Visit. This type of visit is a yearly office visit that focuses on preventive healthcare. Providers should review risk factors, and develop a personalized prevention plan of care for the patient. The overarching goal is for Medicare to begin providing more [...]
Community Health Network, a nonprofit health system with sites throughout the state of Indiana, recently entered into a settlement with the Department of Justice to resolve allegations related to false claims submitted to the Medicare and Medicaid programs. Specifically, it was alleged that between the late 1990s and October 2009 Community Health Network had contracts [...]