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Fraud Awareness and Deficit Reduction Act (DRA)

Date:
November 21, 2019

To: All Providers

Health care organizations subject to Section 6032 of the Federal Deficit Reduction Act of 2005 (DRA) are required to educate their providers and contractors about the False Claims Act as well as the organization’s policies and programs for detecting and preventing fraud, waste and abuse. This information is available for your review on our website, or by clicking below.

Recent Articles

  • Individual Provider Recontracting Initiative
    We will be amending and restating our existing contracts. Starting next month, all directly contracted individual providers will be sent an updated contract. The New York State Department of Health (DOH) requires that each provider sign and return their amended/restated contract.
  • New Digital Provider and Facility Reference Manual
    We’ve upgraded our Provider and Facility Reference Manual, which is now available in digital format. The new manual offers a better, more interactive user experience. Here, we highlight some of the new features.
  • Updates to Screening for Hepatitis C Virus (HCV) in Adults
    Hepatitis C virus (HCV) is reportedly the most common blood infection in the country. The U.S. Preventive Services Task Force has updated the recommendation for HCV screening in March 2020 to now include all adults ages 18 to 79 without known liver disease, regardless of their risk for infection.
  • Update to Spine Preauthorization Process
    To help streamline the preauthorization process for spine procedures and injections, all these requests will be submitted directly to our Utilization Management Department beginning October 1, 2020. We will no longer require any requests to be submitted through Palladian Health.
  • Care at Home Expanded for Medicare Advantage Patients
    Beginning on July 7, more Medicare Advantage patients will be eligible to enroll in a new extension of the Care at Home program -- Care at Home℠ On Call -- which offers some urgent care in-home services. Care at Home On Call will be offered to newly enrolled Medicare Advantage members.

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