What's New

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

October 9, 2020

Update on Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic A-09-20-01000

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Enforcement Actions

October 16, 2020; U.S. Attorney's Office; Western District of Texas

Federal Grand Jury in San Antonio Indicts Two in Health Care Fraud Scheme

October 15, 2020; U.S. Attorney's Office, District of Connecticut

Avon Man Allegedly Involved in Wide-Ranging Health Care Fraud Schemes Arrested

October 14, 2020; U.S. Attorney's Office, District of New Jersey

Medical Device Maker to Pay $18 Million to Settle Allegations of Improper Payments to Physicians

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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