The switch to ICD-10 was expected to make upcoding in medical billing harder. First, some background: The World Health Organization is the public health arm of the United Nations. Since 1948, WHO has been responsible for updating the International Classification of Diseases (ICD), a worldwide system for collecting, processing, classifying and processing statistics about diseases. The most recent version of the ICD is ICD-10, or tenth edition, which WHO published in 1999. How ICD Codes Are Used … [Read more...]
Whistleblower Confidentiality Agreements: Feds Take Strong Action to Protect Employees
Many companies require their employees to sign confidentiality agreements that prohibit the employees from disclosing non-public information about the company to outsiders. In general, these confidentiality agreements aim to protect a company’s proprietary information that gives it an advantage over its competitors; things like trade secrets, inventions, customer lists and strategic plans. Recently, however, a growing number of companies have written whistleblower confidentiality agreements … [Read more...]
ETF Fraud on the SEC’s Radar: Compliance Office Targets Exchange-Traded Funds
The Securities and Exchange Commission’s Office of Compliance Inspections and Examinations recently announced its priorities for 2016. The OCIE conducts examinations of the securities industry with the goal of improving the integrity of the capital and securities markets. The OCIE focuses on improving compliance, preventing securities fraud, monitoring risk and advising the full Commission on policy. One of the OCIE’s priorities for 2016 is to closely examine exchange-traded funds, known as … [Read more...]
OIG Work Plan Provides Strong Clues on Trends in Healthcare Fraud
The U.S. Department of Health and Human Services (HHS) is the federal agency that runs the Medicare and Medicaid programs. Within the Department, the Office of the Inspector General (OIG) is charged with preventing fraud on the Medicare and Medicaid programs, and identifying and holding accountable those that have abused their role as healthcare providers. OIG conducts audits, investigations, and evaluations of Medicare and Medicaid, and works closely with attorneys within HHS and at the U.S. … [Read more...]
SEC Whistleblower Attorney Guide: What the SEC Program Is and How Best to Use It
Whistleblowers have become an effective weapon in the fight against fraud, so not surprisingly, they have been embraced - and supported - by a growing array of new laws and programs. One of the most prominent recent initiatives is the Securities and Exchange Commission's Office of the Whistleblower. This program offers individuals an easy way to do the right thing and sound the alarm on financial wrongdoing. But it is a program that is unique in key aspects - and potential whistleblowers need to … [Read more...]
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