Dr. R. A. Foxworth, FICC, MCS-P
Each February, the U.S. government releases its financial statements for the previous year. Up until the writing of this article, it never dawned on me that I could actually read and review the financial statements of our government. In the report that was released in February 2016, our government reported $3.2 trillion in assets, with the single biggest asset being $1.2 trillion in loans, primarily made up of student loans that were owed to the government. Additionally, it was reported that our government held $21.5 trillion in liabilities, giving our country a net worth of negative $18.2 trillion. A number that has steadily gotten worse over the last 3 years and is not expected to improve with the 2016 financial report to be released later this month.
As our country continues to bleed money, our government will continue to invent ways to stem the flow. If they were looking for a pot of gold, they found one in investigating healthcare fraud and abuse. It is no secret that audits are on the rise, but maintaining the integrity of health insurance programs is not the only driving force behind the increased financial investment from a financially strapped government into The Health Care Fraud and Abuse Control Program. For every $1 invested, they receive a return of $6.10. Since 2009, the Department of Justice has recovered more than $17.1 billion for the federal government with additional billions of dollars recovered for state health programs.
Due to the success of the program, more money is being invested to enhanced fraud detection technology, enhanced provider screening and enrollment requirements, and partnerships with private insurers to aid in investigations. Audits will continue to rise in 2017. Now is the time to audit your charts, your billing, and review your utilization of ChiroHealthUSA. Are you reviewing your monthly reports to see who is being signed up for ChiroHealthUSA, monitoring patient renewals and utilizing the program for all of your eligible patients?
With today’s unending flow of information, we can’t go a day without seeing headlines, posts, and tweets about providers across health care being audited, fined and some even convicted. We tell ourselves “It won’t happen to me,” but the reality is that it easily could. Your license is your livelihood. Your families, employees, and patients are depending on you. If you want a refresher course for your and your team on how to best utilize ChiroHealthUSA in your practice, watch CHUSA 101. This recorded presentation has been viewed hundreds of times over the years and has helped many providers and their teams identify and correct potential risks and missed opportunities in their practice. Investing 20 minutes could save you thousands down the road and help you sleep better at night.
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Why is the Discount Challenge prize amount $15,024? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $15,024 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.