HCC Blog by Caridad

Have you ever wondered what career opportunities are available with the Federal Government in the Office of the Inspector General? Well here is a link to the website to check that out from time to time! OIG Careers USAJOBS.GOV https://oig.hhs.gov/careers/

 Here are some highlights from the press release: The government alleged that BioTelemetry — with the knowledge of then senior management — diverted certain federal beneficiaries’ ECG Data to India when the domestic workflow became backlogged. “Federal health care beneficiaries deserve care, including remote cardiac monitoring, that complies with federal law and is provided by qualified clinical personnel,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s settlement reminds all providers that they must observe those standards and reflects the department’s commitment to pursue knowing violations of federal health care program requirements.”  The United States further alleged that most of the offshore technicians tasked with reviewing ECG Data for federal healthcare program beneficiaries did not have the basic qualifications to perform the tests in question.  In connection with the settlement, BioTe...

This Risk Adjustment 101 program is designed for individuals who are either new to the risk adjustment process or desire a refresher of the basics.  The primary audience for this program includes:  Medicare Advantage (MA) and Medicare Advantage-Prescription Drug (MA-PD) organizations; Regional and Employer Group Health plans;  Demonstration projects;  Program of All-Inclusive Care for the Elderly (PACE) organizations;  Specialty plans; and Third party submitters contracted to submit data on behalf of risk adjustment organizations.  This is good for us risk adjustment coders to have a knowledge about this, but it is mostly used by the health plans.  https://www.csscoperations.com/internet/csscw3_files.nsf/F/CSSC2013_RA101ParticipantGuide_5CR_081513.pdf/$FILE/2013_RA101ParticipantGuide_5CR_081513.pdf