FWA Briefs

A pain management practice will pay $625k from a False Claims Act violation. Similar cases give an importance to Fraud, Waste, and Abuse (FWA) protection, and the use of E/M codes would have detected an abnormality on similar claims. Read more to find out how.

The role of nutrition in chronic disease management is especially crucial, as it is a modifiable risk factor for many conditions such as chronic renal failure (CRF), diabetes mellitus (DM), obesity and coronary artery disease (CAD). Payers who bear significant long-term healthcare utilization burdens due to obesity and cardiovascular risk factors may determine that Medical Nutrition Therapy (MNT) preventive coverage is a cost-effective policy approach for their beneficiaries.

The five regional Recovery Audit Contractors (RACs) are ramping up their automated and complex reviews starting this month. The Centers for Medicare & Medicaid (CMS) Medicare Fee for Service (FFS) audit program awarded contracts in October 31, 2016 ....