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A practice will pay more than $340,000 to resolve incident-to error allegations. Was it worth the extra 15%?

Some early adopters of chronic care management (CCM) received overpayments because inadequate oversight allowed overlapping care management services.

Investigators and prosecutors continue to use their coding knowledge to wring big settlements from practices. These tactics have left four physician practices poorer by an average of $218,465, the U.S. Attorney’s Office for Maryland announced on March 16.

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)?
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.


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