2025 LTW

1. Failure to respond to an Additional Documentation Request (ADR) for claim review could result in a referral to this auditing agency
4. government office that regulates and oversees HIPAA
8. Routine waiver of beneficiary co-insurance or deductible is considered this type of violation
10. act that is violated when you up-code or bill for services that are not provided
11. HIPAA-compliant process is used to safely transmit PHI via email

2. This plan outlines the supplier/providers actions to be taken when a compliance violation has taken place
3. Payment to referral sources is a violation of this statute.
4. Routine monitoring of this list should be done to make sure staff have never been convicted of Medicare or Medicaid fraud
5. The Office of Inspector General expects suppliers/providers conduct this on an annual basis
6. Medicare suppliers whose billing patterns significantly differ from their peers
7. Self-reporting of fraud and abuse should be made to this entity
9. Claim review results are reported to Congress, driving potential changes to the Medicare program