Compliance

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National Health Care Fraud Takedown Results in Charges...

Most Defendants Charged and Largest Alleged Loss Amount in Strike Force History 6/22/16 Attorney General Loretta E. Lynch and Department of Health and Human...

Read More National Health Care Fraud Takedown Results in Charges against 301 Individuals for Approximately $900 Million in False Billing
DHHS’ OIG Mid-Year Work Plan...

The U.S. Department of Health and Human Services (DHHS) Office of Inspector General (OIG) recently released an updated Mid-Year Work Plan for fiscal year...

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HHS: Phase 2 of HIPAA Audit Program Begins...

As a part of its continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the HHS Office for Civil...

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Medlearn Matters Special Edition 1615 (SE1615): Zika V...

On February 1, 2016, the World Health Organization (WHO) declared the Zika virus a Public Health Emergency of International Concern (PHEIC)1. According to the...

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JW Modifier: Drug Amount Discarded/Not Administered to...

Effective January 1, 2017, when processing claims for Part B drugs and biologicals, except those provided under Competitive Acquisition Program (CAP), the use of...

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New Unspecified Diagnosis Codes Excluded by CMS for 20...

On May 26, Centers for Medicare & Medicaid Services (CMS) outlined additional unspecified diagnosis codes the agency is excluding from both ICD-9 and ICD-10...

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Add-On Codes: CMS and Payment Policy...

An add-on code is a HCPCS/CPT code that describes a service that, with one exception (see next paragraph), is always performed in conjunction with...

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New CLIA Waived Tests...

On June 24, CMS released a change request informing contractors of new CLIA waived tests approved by the Food and Drug Administration. Since these...

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National Correct Coding Initiative Edits (NCCI)...

Back in 1996, the Centers for Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative (NCCI) to promote correct coding and prevent...

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