Upcoding

Nursing home psychiatrist in federal custody on 52 counts of fraud, including upcoding

Authorities have arrested a nursing home psychiatrist and charged him with 52 counts of healthcare fraud, the U.S. Attorney for the Northern District of Texas announced Thursday.

Latest therapy-billing showdown could be ominous sign for long-term care providers

Latest therapy-billing showdown could be ominous sign for long-term care providers

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Don't let anyone tell you that long-term care operators don't know how to read between the lines. They might not have known to fear a McKnight's Monday news item before it broke, but it definitely has their attention — and apprehension — now.

Hospitalist company with long-term care presence faces federal charges of upcoding

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A hospitalist company that works with thousands of post-acute care facilities is officially facing federal charges that its clinicians routinely overbilled Medicare and Medicaid, authorities announced Tuesday.

Federal government joins upcoding case against hospitalist company operating in LTC facilities

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The federal government has intervened in a whistleblower lawsuit alleging that a large hospitalist company systematically overbilled government health programs, the U.S. Department of Justice announced Monday.

'Targeted' EHR upcoding audits on the way

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The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, according to Acting CMS Administrator Marilyn Tavenner.

Upon further review

Upon further review

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Providers recoiling from recent uptick in therapy claim audits should expect even more scrutiny in the future as regulators look to increase surveillance.

Government will increase EHR upcoding audits, Tavenner says

Government will increase EHR upcoding audits, Tavenner says

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The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, Acting CMS Administrator Marilyn Tavenner said Tuesday.

OIG? OMG! One lump problem

OIG? OMG! One lump problem

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The Office of the Inspector General's recent report about what it calls $1.5 billion in inappropriate Medicare payments to skilled nursing facilities should be yet another wake-up call to providers.

OIG slams SNFs for overbilling

OIG slams SNFs for overbilling

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Nursing home advocates are expected to kick into high-gear defense mode after a new federal report asserted Tuesday that providers are overcharging Medicare to the tune of $1.5 billion annually.

Medicare 'upcoding' accounts for $11 billion in extra costs, investigation finds

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Medicare providers increasingly are using higher-paying codes instead of using less complex, lower-paying codes, an investigation has found. This practices, known as "upcoding," has added $11 billion or more to their fees over 10 years.

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