OIG Guidance on Healthcare Discounting: What Providers Need to Know (2026 Compliance Guide)
Short Answer The Office of Inspector General (OIG) allows certain healthcare discounts under federal law—but only when they are properly structured, transparent, and not tied to improper inducement. Providers who offer discounts without a compliant framework may face scrutiny under the Anti-Kickback Statute, Civil Monetary Penalties Law, and False Claims Act. What Is OIG […]
Keep Audits from Sinking Your Practice
How to Protect Your Chiropractic Business From Audits (Without Losing Sleep) Medical audits pose one of the biggest risks to chiropractic businesses today. An insurance audit can quickly lead to denied claims, repayment demands, and serious financial stress. As a result, many chiropractors worry about the possibility of an audit. In some cases, a single […]
Dual-Fee Schedule: Common Violations
Understanding Dual Fee Schedule Violations Dual fee schedule violations can occur when healthcare providers use improper billing or fee-setting practices. These issues often arise when a provider charges different fees for the same service based on how a patient pays, such as insurance versus self-pay. As a result, these practices may lead to discrimination, compliance […]
Chiropractors: What Your Patient’s Need to Know about Medicare Part C Plans
Medicare Part C, also known as Medicare Advantage, is a type of health insurance plan offered by private companies approved by Medicare. These plans provide an alternative way to receive Medicare benefits, combining coverage for hospital (Part A) and medical (Part B) services, and often include additional benefits not covered by Original Medicare, such as […]
Forest Park TX kickback scheme totaling over 40 million dollars
Kickbacks are still not allowed, much to the surprise of a Forest Park TX medical group. This story coming from Dallas News‘ federal courts reporter Kevin Krause. The Forest Park Medical Center federal bribery and kickback trial in Dallas resulted in landmark convictions against the hospital’s managers and doctors. It also exposed Texas’ longstanding failure […]
2018 was a banner year for HIPAA compliance issues
At patient options we always want to keep you up to date with what is happening in our world of compliance. Lets look at the 2018 report of major trends. After a relatively slow first six months, 2018 turned into an active year for HIPAA enforcement, with the Department of Health and Human Services’ (HHS) […]
AI is coming to detect healthcare fraud
Forbes’ insights brings us this article about the future of healthcare fraud detection, How AI Can Battle A Beast—Medical Insurance Fraud. This is a future of fraud detection that is inevitable. With the rise of the amount healthcare data it is almost a forgone conclusion that computers are going to be integrated into battling healthcare […]
Even the big dogs are getting caught up in fraud.
Coming to us via NBC26 we see reports of Walgreens settling a huge case of fraud in the state of Wisconsin. Even the large corporations can have what we hope are oversights in their plans so your compliance is essential to keeping your practice safe. The U.S. Attorney in the Eastern District of Wisconsin says […]
In 2018 the DOJ recovered 2.5 Billion dollars from Healthcare Fraud
Welcome to the new year. Lets begin by looking back. The DOJ has just released it’s final total funds recovered figure for 2018… It is 2.5B dollars. Lets take a look right from the horse’s mouth on the justice.gov website. Keep in mind that this is just federal dollars that we are talking about here […]
AI in healthcare fraud detection is here! Protect yourself with Patient Options!
It is here folks! Machine learning and AI are going to be used in a proactive way to detect the fraud in the healthcare market. The investigators will be well down the trail of knowing who to audit before they even send the letter they will have a pretty strong idea of what they will […]