Part B News | Editors' Blog

Gym owner's $57K health care fraud charged dead people for workouts

by: Roy Edroso Nov 17, 2015

You don't have to be a doctor or even in the health care business to commit health care fraud. A judge court just sentenced an Orchard Park, N.Y., gym owner to three years probation and 100 hours of community service for defrauding private insurers for fake fitness sessions -- including a couple allegedly attended by dead people.

4 new physician targets in 2016 OIG Work Plan

by: Part B News staff Nov 2, 2015

Ensure your claims for prolonged services are documented and justified because the HHS Office of Inspector General (OIG) will focus on that area, according to one new issue in its 2016 Work Plan.

Uh-oh. Watch that PHI disclosure

by: Richard Scott Oct 9, 2015

Maryland's troubled health insurance website improperly stored Social Security numbers and other patient information in a way that put enrollees at risk of identity theft, according to a legislative audit released Friday.

CMS: Keep EHR attestation records for six years in some form

by: Grant Huang Sep 12, 2011

You would be wise to save documentation – in whatever format you can – that shows you were honest and accurate in attesting to meaningful use for the Medicare electronic health record (EHR) incentive program, which is currently doling out money pretty much on the honor system, CMS says. Now the agency has issued its strongest statement yet on the need to preserve documentation for the future meaningful use auditing program.

CMS to test electronic method for you to respond to record requests

by: Grant Huang Aug 23, 2011

The next time you get a request for records from your carrier or recovery audit contractor (RAC), you would be able to send it electronically under a new CMS pilot program. The Electronic Submission of Medical Documentation (esMD) lets you send any requested record as a PDF document, which typically means you scan or convert the required documents into PDFs. This could reduce the time it takes to meet a records request, although you will probably need to go through your claims clearinghouse to submit information via esMD.

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