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Question: How does the Supplemental Medical Review Contractor (SMRC) determine which reviews to perform? Does SMRC work for CMS or our Medicare administrative contractor (MAC)?
It's a familiar scenario: A provider is accused of letting unqualified, improperly supervised employees perform services and billing for their work. It is a scenario we associate with small practices, not a large health system with multiple locations and — one assumes — a robust compliance policy.
According the Department of Justice (DOJ), Jacksonville, Fla.-based First Coast Cardiovascular Institute (FCCI) has stumbled on a secret for nearly tripling the amount of money it owes to federal health care programs.
Don't believe the myth that enforcers only keep the big fish in health care fraud schemes — hospitals, diagnostic providers, pharmaceutical companies and so on — and let the small fry such as doctors and medical practices go.
HHS Secretary Tom Price has been dogged by the controversy over the use -- and the cost -- of at least 24 chartered flights since he became secretary. To make amends he offered to pay for the cost of his seat on these flights: approximately $52,000.

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