BC Advantage - 2023 Issue 9
Monthly Spotlight on Fraud, Waste, and Abuse
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Article Overview
This article is a monthly enforcement-focused roundup for healthcare compliance, coding, and audit audiences. It summarizes several fraud, waste, and abuse cases involving federal relief programs, Medicare billing, diagnostic testing, opioid prescribing, device reuse, identity theft, and record falsification. The piece is intended to help readers understand the types of misconduct being highlighted and why these matters are relevant to compliance oversight.
Why This Topic Matters
The article is relevant to healthcare organizations and compliance teams that monitor billing integrity, documentation practices, controlled-substance prescribing, and patient safety risks. It provides a high-level view of current enforcement themes without serving as a coding reference.
What You Will Learn
- The kinds of fraud, waste, and abuse cases being highlighted in a monthly compliance roundup.
- How different enforcement cases intersect with healthcare operations, Medicare billing, and patient safety.
- The general compliance themes associated with pandemic relief, diagnostic testing, prescribing, and device handling.
- The types of organizations, providers, and practices that may be implicated in enforcement actions.
Who Should Read This
- Healthcare compliance professionals
- Medical coders
- Auditors
- Physicians and advanced practice providers
- Practice managers
- Revenue cycle teams
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