In the absence of top level oversight and a strong compliance effort by hospitals, small abuses tend to grow and compound until auditors or whistle blowers bring them to the attention of the federal government. Lawsuits and enforcement actions then result in paybacks, fines, operating restrictions, and management changes. Every now and then, someone even goes to jail.
This is DOJ shakedown because this firm was being bought by CHS.Janet Reno did this all time and Holder learned from the master !
She would sue big companies just before a merger happened and leak stories to her Dem media pals and get millions so the lawsuit went away and the merger went thru.
This is The Evil White hating Holder we are talking about !
The government is creating the environment for coding errors by promoting extreme complexity. Look at the proliferation of codes in ICD-10; this will do nothing to improve health care, but it will obviously create the opportunity for the government to threaten providers and take money back. Now, if you work in the compliance industry or in government, that’s a good thing for you personally in the short run, but this parasitic activity will eventually kill the host, aka, healthcare providers.
The answer is not better compliance teams for providers. Providers really need to critically look at either they should accept Federal health programs in the first place. And if they do accept Medicare et al, providers should take a critical approach that only accepts patients with very low coding risk and acceptable profit margins (which could mean very few or no Medicare patients).