Keeping compliance and quality of care/patient safety in separate boxes puts health care organizations at risk of enforcement actions, according to a top official from the HHS Office of Inspector General (OIG). Oversight of quality and patient safety should be incorporated into compliance processes to help organizations “mitigate risk of patient harm,” as OIG explained in its new General Compliance Program Guidance (GCPG), and that includes the risk assessment.^[1]

The cooperation credit that Baptist Health System in Florida earned jumps out in its False Claims Act (FCA) settlement with the U.S. Department of Justice (DOJ) over waivers of patient copays, coinsurance and deductibles.^[1] DOJ alleged that Baptist Health subsidiaries offered these discounts to certain groups of patients to coax them to receive or refer services there.

A Michigan physician and his practice agreed to pay $2 million to settle false claims allegations over ear-care services provided by physician assistants (PAs) without supervision, the U.S. Attorney’s Office for the Eastern District of Michigan said May 8.^[1]

In a new Medicare transmittal (12604) on split/shared evaluation and management (E/M) services, CMS again shines a light on the performance of the “substantive portion,” but providers are still more or less in the dark about documentation requirements for medical decision-making (MDM).^[1]