Obama Administration Warns Providers Over Medicare Fraud

The Obama administration, reacting to recent speculative news reports about alleged upcoding and other improprieties involving Medicare reimbursements, issued a warning to healthcare providers on Monday: “We will not tolerate healthcare fraud.”

The New York Times reprinted a letter mailed to provider associations such as the American Hospital Association in which Kathleen Sebelius, secretary of U.S. Department of Health and Human Services, and U.S. Attorney General Eric Holder, warn providers that their respective agencies, in addition to the FBI and other law enforcement organizations, will be “monitoring these trends” and will take action. “Law enforcement will take appropriate steps to pursue health providers who misuse electronic health records to bill for services never provided.”

CMS to Pilot Controversial RAC Audits Targeted at 99215 CPT Code

The Centers for Medicare & Medicaid Services’ Recovery Audit Contractor (RAC) program will pilot a series of audits to examine the use of the CPT evaluation/management code 99215 by physicians in the American South.

The auditing program pilot has not been officially announced, but medical associations have been warning their membership of it since early September.

“The AMA strongly opposes RAC review of E&M codes, including CPT code 99215, and strongly urges CMS to rescind its approval of RAC review of CPT code 99215 and reject any other pending RAC requests to audit E&M codes,” protested the American Medical Association in a Sept. 11 letter.

cyber-spying-spyware

FTC and State AG Team Up on Rental Spying Debt Collection Case

You know what’s creepy? This story:

The FTC and Illinois Attorney General Lisa Madigan this week announced a settlement with a rental company that digitally spied on consumers who had leased laptop computers. Madigan said the company used the spyware as a debt collection tool to locate customers who had fallen behind on as little as one payment on their lease agreement.