Medicare, Medicaid & Private Payor Updates
Genetic Testing Fraud Prosecutions are on the Rise Around the Country. Are Your Genetic Testing Practices Compliant?(August 13, 2019): Over the last year, a number of genetic testing fraud investigations...
OIG’s Renewed Interest in Orthotic Audits and Investigations: What Your DME Company Needs to Know(February 8, 2019): A series of recent reports out of the Department of Health...
Audits of Telehealth Services are Increasing. Do Your Telehealth Services Meet Applicable Requirements?(December 21, 2018): The use of “telehealth” technologies to diagnose and treat...
EKRA: Laboratories, Treatment Homes and Clinical Treatment Centers Now Face Increased Enforcement and Penalties for Kickback Tainted Claims that are Reimbursed by Private Payors.Eliminating Kickbacks in Recovery Act (EKRA) (December 3, 2018): On October 24th,...
Read More Posts From This CategoryDental Audits & Compliance
The Dangers of Billing Payors for the Services of a Non-Credentialed Dentist / Non-Participating Dentist(August 17, 2019): Over the last year, we have seen a significant increase in...
Aetna’s SIU is Actively Auditing Dental Claims. Are Your Dental Services Compliant with Applicable Regulatory and Contractual Requirements?(January 3, 2019): Slowly but surely, the percentage of adults and children with...
Mobile Dentistry in Texas – An Overview of Regulatory Risk Areas to be Considered(December 7, 2018): Each state sets their own licensure requirements, rules and...
UPIC Dental Audits (Such as Qlarant Dental Audits) Have Been Initiated. Is Your Practice Ready for its Medicare Dental Claims or Medicaid Dental Claims to be Audited?(July 3, 2018): While a number of Medicare Advantage Plans now offer supplemental...
Dental Claims Audits are on the RiseBoth Medicaid and private payor dental claims audits are increasing around the country. (December...
Read More Posts From This CategoryHome Health & Hospice
Home Health Agency Alert: The Review Choice Demonstration Project start dates for Ohio, Texas, North Carolina and Florida are Around the Corner!(August 7, 2019): This article further updates our articles of February 19th and... [Read more of this review]
Home Health Agency Alert: The Review Choice Demonstration Project is Moving Forward in Illinois Effective June 1, 2019(April 9, 2019): This article updates our article of February 19 on the lifting... [Read more of this review]
CMS has Ended its Moratorium on New Home Health Agencies in Texas, Illinois, Michigan and Florida. Unfortunately, the Lifting of the Moratorium Isn’t Necessarily a Good Thing for Existing Home Health Agencies.(February 19, 2019): CMS has now ended, at least for the current time, the moratorium... [Read more of this review]
Texas Prosecutors are Aggressively Targeting Criminal Home Health Fraud(January 9, 2019): Despite real progress being made with respect to regulatory... [Read more of this review]
Read More Posts From This CategoryRegulatory Issues | Privacy | Other
Recent Changes to DOJ’s “Justice Manual” Addressing De-Facto Regulations and Agency Guidance Documents(December 27, 2018): On November 16, 2017, Attorney General Jeff Sessions issued... [Read more of this review]
Is ePHI Encryption Required? The Failure to Properly Protect ePHI Can be Quite Costly.(June 27, 2018): Violations of the Health Insurance Portability and Accountability... [Read more of this review]
Sexual Harassment: Cases Against Texas Physicians in 2017(January 26, 2018): From Churches to Congress, sexual harassment and assault charges... [Read more of this review]
Looking a Gift Horse in the Mouth (or how to deal with holiday gifts)(December 8, 2015): Last month we discussed performing audits in your practice.... [Read more of this review]
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