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Anatomy of an Alleged False Claims Act Violation: The Providence Health & Services Lawsuit
Manage episode 215937209 series 2288292
Content provided by RACmonitor. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by RACmonitor or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
A False Claims Act lawsuit has been filed by Integra Med Analytics against Providence St. Joseph Health, seeking $188.1 million related to alleged upcoding of Medicare claims.
According to media reports, Integra made the discovery of allegedly unwarranted major complication and comorbidity secondary codes. In its investigation, Integra identified J.A. Thomas and Associates (JATA) as the clinical documentation improvement consultancy for Providence. The lawsuit alleges Providence and JATA were "pushing doctors to make unwarranted diagnoses" and "using leading queries to change doctors' original diagnoses."
Reporting our lead story during this edition of Monitor Mondays will be False Claims Act attorney Mary Inman, partner in the London law office of Constantine Cannon. Also on board reporting the data analytics associated with this developing story will be senior healthcare analyst Frank Cohen, director of business intelligence and analytics for DoctorsManagement.
The broadcast rundown also will include:
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.
- Monday Focus: Michael Salvatore, MD, FACP reports on the ancient practice of alchemy and how its modern-day equivalency is turning health into disease. Dr. Salvatore is the physician advisor and medical director of the palliative care team at Beebe Healthcare in Delaware.
- Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron continues his reporting on the perennial question, “should I refund an overpayment?” He will pose the question as a listener quiz.
- Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, reports on all the latest hot topics.
Monitor with us™
305 episodes
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Manage episode 215937209 series 2288292
Content provided by RACmonitor. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by RACmonitor or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
A False Claims Act lawsuit has been filed by Integra Med Analytics against Providence St. Joseph Health, seeking $188.1 million related to alleged upcoding of Medicare claims.
According to media reports, Integra made the discovery of allegedly unwarranted major complication and comorbidity secondary codes. In its investigation, Integra identified J.A. Thomas and Associates (JATA) as the clinical documentation improvement consultancy for Providence. The lawsuit alleges Providence and JATA were "pushing doctors to make unwarranted diagnoses" and "using leading queries to change doctors' original diagnoses."
Reporting our lead story during this edition of Monitor Mondays will be False Claims Act attorney Mary Inman, partner in the London law office of Constantine Cannon. Also on board reporting the data analytics associated with this developing story will be senior healthcare analyst Frank Cohen, director of business intelligence and analytics for DoctorsManagement.
The broadcast rundown also will include:
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.
- Monday Focus: Michael Salvatore, MD, FACP reports on the ancient practice of alchemy and how its modern-day equivalency is turning health into disease. Dr. Salvatore is the physician advisor and medical director of the palliative care team at Beebe Healthcare in Delaware.
- Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron continues his reporting on the perennial question, “should I refund an overpayment?” He will pose the question as a listener quiz.
- Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, reports on all the latest hot topics.
Monitor with us™
305 episodes
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Similar to Monitor Mondays
America is more divided than ever—but it doesn’t have to be. Open to Debate offers an antidote to the chaos. We bring multiple perspectives together for real, nonpartisan debates. Debates that are structured, respectful, clever, provocative, and driven by the facts. Open to Debate is on a mission to restore balance to the public square through expert moderation, good-faith arguments, and reasoned analysis. We examine the issues of the day with the world’s most influential thinkers spanning s ...
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Although the world is becoming mostly sedentary, our bodies still require a wide variety of daily movements in order to work well. Many of us struggle to get regular exercise, but even that can fall short of nourishing the body from head to toe. How can we move more—a lot more—when we have sore, stiff parts and overly busy lifestyles? Join Katy Bowman M.S., biomechanist, author, and movement educator as she combines big-picture lessons on biomechanics, kinesiology, physiology, and natural hu ...
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TED is a nonprofit devoted to ideas worth spreading. On this video feed, you'll find TED Talks to inspire, intrigue and stir the imagination from some of the world's leading thinkers and doers, speaking from the stage at TED conferences, TEDx events and partner events around the world. This podcast is also available in high-def video and audio-only formats.
…
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From the stuff your mother never told you, to the stuff your doctor never learned, On Health features taboo-busting conversations that demystify and de-stigmatize our bodies, all while bridging the gap between conventional medicine and wellness. Join Yale-trained MD & midwife Aviva Romm and her line-up of expert guests as they discuss everything from periods to menopause, sex to reproductive health politics, and motherhood to mental health. Each week, Dr. Romm will be exploring the science a ...
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