What's New

December 5, 2022

Fall 2022 Semiannual Report to Congress

December 1, 2022

Insights on Telehealth Use and Program Integrity Risks Across Selected Health Care Programs During the Pandemic OEI-02-22-00150

November 25, 2022

Medicare Improperly Paid Physicians for Co-Surgery and Assistant-at-Surgery Services That Were Billed Without the Appropriate Payment Modifiers A-01-20-00503

National Government Services, Inc., Accurately Calculated Hospice Cap Amounts but Did Not Collect All Cap Overpayments A-06-21-08004

Enforcement Actions

December 1, 2022; U.S. Department of Justice

New York Diagnostic Testing Facility Owners Sentenced for Health Care Fraud Scheme

December 1, 2022; U.S. Attorney's Office, Western District of Missouri

Lenexa Man, Woman Indicted for $2.9 Million Medicare Fraud Conspiracy

November 30, 2022; U.S. Department of Justice

Group Home Owners Sentenced in $1 Million Medicare Fraud Scheme

What's Trending

1. Medicare Providers Did Not Always Comply With Federal Requirements When Billing for Advance Care Planning
2. Medicare Improperly Paid Physicians for Co-Surgery and Assistant-at-Surgery Services That Were Billed Without the Appropriate Payment Modifiers
3. Insights on Telehealth Use and Program Integrity Risks Across Selected Health Care Programs During the Pandemic
4. New York Claimed $196 Million, Over 72 Percent of the Audited Amount, in Federal Reimbursement for NEMT Payments to New York City Transportation Providers That Did Not Meet or May Not Have Met Medicaid Requirements
5. Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018