HHS imposes a $4.3 million civil money penalty for violations of the HIPAA Privacy Rule

On , in Industry News, by AQ-IQ LLC

Action marks first civil money penalty issued by HHS for HIPAA Privacy Rule violations The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a Notice of Final Determination finding that Cignet Health of Prince George’s County, Md., (Cignet) violated the Privacy Rule of the Health Insurance Portability and […]

RACs Post 60 New Issues, 41 for Medical Necessity

On , in Industry News, by AQ-IQ LLC

Region C List Riddled with Errors Two of the CMS Recovery Audit Contractors (RAC) posted newly approved issues last week to their public websites, as required by CMS before widespread review of those issues can begin. Connolly Healthcare, the RAC for CMS Region C posted 36 new issues on their Approved Issues webpage, on Wednesday, […]

RACs Post 60 New Issues, 41 for Medical Necessity

Region C List Riddled with Errors Two of the CMS Recovery Audit Contractors (RAC) posted newly approved issues last week to their public websites, as required by CMS before widespread review of those issues can begin. Connolly Healthcare, the RAC for CMS Region C posted 36 new issues on their Approved Issues webpage, on Wednesday, […]

Auto Denial of Claims Submitted With a GZ Modifier

On , in Documents, by AQ-IQ LLC

This document is from: MLN Matters Article #:MM7228 Posted: February 4, 2011                                Related CR#: 7228 Effective Date: July 1, 2011 Auto Denial of Claims Submitted With a GZ Modifier The GZ modifier indicates that an Advance Beneficiary Notice (ABN) was not issued to the beneficiary and signifies that the provider expects denial due to a […]

Healthcare Fraud and Abuse Control Program Annual Report

On , in Documents, by AQ-IQ LLC

From the OIG: Fiscal Year 2013 Read the Press Release Fiscal Year 2012 Read the Press Release Fiscal Year 2011 Read the Press Release Read the Fact Sheet Fiscal Year 2010 Fiscal Year 2009 Fiscal Year 2008 Fiscal Year 2007 Fiscal Year 2006 Fiscal Year 2005 Fiscal Year 2004 Fiscal Year 2003 Fiscal Year 2002 […]

Compendium of Unimplemented OIG Recommendations

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Compendium of Unimplemented OIG Recommendations The Compendium consolidates significant unimplemented monetary and nonmonetaryrecommendations addressed to the Department of Health & Human Services (HHS) toprovide information to interested parties about outstanding recommendations that, ifimplemented, have the potential to result in cost savings and improvements to programefficiency and effectiveness. These recommendations resulted from our audits andevaluations that […]

Connolly Posts 77 New Issues, 216 DRGs

On , in Industry News, by AQ-IQ LLC

23 New Issues Approve Medical Necessity Review for 70 DRGs Connolly Healthcare, the Recovery Audit Contractor (RAC) for 17 states posted 77 new issues on their Approved Issues webpage, late in the day on Friday, January 14, 2011. Once again, continuing the pattern that healthcare providers have come to expect from the 4 RACs and […]

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud

On , in Industry News, by AQ-IQ LLC

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud Joint DOJ & HHS  efforts result in largest sum ever recovered in single year; new rules under the Affordable Care Act will keep fraudulent providers and suppliers out of Medicare, Medicaid, CHIP and avoid payments […]

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud Joint DOJ & HHS  efforts result in largest sum ever recovered in single year; new rules under the Affordable Care Act will keep fraudulent providers and suppliers out of Medicare, Medicaid, CHIP and avoid payments […]