More Texas Medicaid Dental Audits Are Coming in 2017!
After learning from its previous missteps, the IG’s Office appears to now be taking a more systematic approach in its audit and investigation of Medicaid pediatric care cases.
Home Health Pre-Claim Reviews Are Here!
The home health “Pre-Claim Review” demonstration project has now started and will be in place for at least the next three years.
CMS Seeks to Overhaul Medicare Claim Appeal Process
The Centers for Medicare and Medicaid Services (CMS) has announced a series of proposed changes to the Medicare administrative claim appeal process. The new rules primarily impact the Administrative Law Judge (ALJ) level of review, and CMS has indicated that the purpose of these changes is to help reduce the backlog of pending ALJ hearing requests.
Health Law ArticlesHome Health Pre-Claim Reviews Are Here! Medicare Revocation Actions / Medicare Deactivation Actions: How Should You Respond? CMS Seeks to Overhaul Medicare Claim Appeal Process CMS Announces Home Health Pre-Claim Review Demonstration Project for Five States CMS Expands Overpayment Claim Settlement Process to Include Part A Providers With Pending ALJ Appeals Read More Posts From This Category
Dental Law ArticlesMore Texas Medicaid Dental Audits Are Coming in 2017! Exclusion Screening and Background Checks in Dental Practices Medicare Dental: Significant Overpayments Have Been Made to Hospitals Dentists Participating in the Medicaid Program Must Exercise Caution to Avoid False Claims Act Liability Medicaid Dental Audit: Exclusion Screening Issues Read More Posts From This Category
False Claims ActFalse Claims Act: Whistleblower Cases Have Continued to Rise Since the Passage of the Affordable Care Act
Number of whistleblowers on the rise (March 3, 2015): The federal False Claims Act... [Read more of this review]Dental Fraud Settlement — $5.05 Million to be Paid by Oklahoma Dental Practice in Medicaid Case.
(November 10, 2014): Dental fraud investigations and audits are becoming increasingly... [Read more of this review]OCR to Covered Entities, Business Associates: Encryption Is Your Best Defense against HIPAA Violations
(May 29, 2014) On April 22, 2014, the U.S. Department of Health and Human Services... [Read more of this review]Read More Posts From This Category
Business & Transaction ArticlesCell Tower Ground Lease Renewals and Purchases
A landowner/ground lessor considering a renewal or easement buyout of his cell tower... [Read more of this review]Cloud Storage Providers & BAAs – Where is Your Data?
In a recent webinar presentation, I was asked whether I believed one of the many... [Read more of this review]OIG Proposes New Anti-Kickback Law Safe Harbors
(November 10, 2014): The U.S. Department of Health and Human Services Office of Inspector... [Read more of this review]Read More Posts From This Category