Medicare Compliance & Reimbursement - 2010 Issue 19
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Article Overview
This article covers federal health care fraud enforcement results reported by the OIG, including investigation activity, criminal and civil outcomes, and examples of settlements involving Medicare-related allegations. It is relevant to compliance, auditing, revenue integrity, and coding professionals who follow fraud-and-abuse enforcement trends and government oversight activity.
Why This Topic Matters
Health care fraud enforcement can affect compliance programs, documentation practices, and billing oversight across provider organizations. The article highlights government enforcement priorities and illustrates the kinds of allegations that can lead to investigations and settlements.
What You Will Learn
- How federal health care fraud enforcement activity was summarized in a government report
- What broad categories of investigations and settlements were highlighted
- Why fraud-and-abuse reporting is relevant to compliance and billing oversight
- How selected case examples illustrated enforcement activity at a high level
Who Should Read This
- Medical coders
- Compliance officers
- Billing managers
- Revenue integrity staff
- Health care administrators
- Auditors
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