decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 11 (November)
Compliance: 3 ortho practices pay big fines for reimported hyalganate claims
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Article Overview
This article covers a federal compliance case involving orthopedic clinics, reimported viscosupplement products, and allegations of improper billing to government payers. It summarizes the Department of Justice’s position, the role of Medicare and Medicaid, and the resulting settlements, making it relevant to compliance staff, orthopedic practices, billing professionals, and health care legal teams.
Why This Topic Matters
It highlights a reimbursement compliance risk tied to product sourcing and government program billing, with significant financial consequences for providers.
What You Will Learn
- Why reimported medical products can trigger billing compliance concerns
- How federal and state enforcement authorities responded to the alleged conduct
- What kinds of provider organizations were involved in the settlements
- How this type of issue affects orthopedic practices and billing compliance
Who Should Read This
- Orthopedic practice administrators
- Medical billing and coding professionals
- Compliance officers
- Health care attorneys
- Revenue cycle staff
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