Medicare, Medicaid & Private Payor Updates
Telemedicine Related Medicare Revocation Actions for Failure to Provide Access to Documentation are on the Rise!(September 25, 2020): In recent years, many individuals (especially younger members...
Sober Home and Recovery Residence Fraud Enforcement Efforts are on the Increase – Are Your Sober Home Business Practices Legal?(September 12, 2020): This has been a rough year for sober home and recovery residence...
Medicaid After-Hours Claims Audits (CPT 99050 & CPT 99051) by State Medicaid Regulators are Continuing. Are Your Medicaid After-Hours Claims Compliant?(June 3, 2020): By 2027, national health spending is expected to exceed $6 trillion. ...
The Coronavirus Aid, Relief and Economic Security (CARES) Act: Provisions Relevant to Healthcare ProvidersBy Michael Cook, Jennifer Papapanagiotou & Andy Lynch – Partners at Liles...
Operating a Medical Practice in Texas during the COVID-19 Pandemic(March 30, 2020): The COVID-19 pandemic is unprecedented and has resulted in President...
Coronavirus Update – New FAQs and Toolkits for Telehealth, Telemedicine & Medicare Provider Enrollment(March 27, 2020): Liles Parker published an article covering CMS’ blanket waiver...
Read More Posts From This CategoryDental Audits & Compliance
United Concordia Dental and its SIU are Actively Auditing Dentists Around the Country.(September 15, 2020): There are approximately 1.4 million active duty service members...
Overview of Dental Claims Audits and Investigations by Medicaid and Private Payors in 2019(March 4, 2020): Many dentists and dental practices around the country are glad...
SIU Dental Audit Reviews by DentaQuest, Delta Dental and Cigna Can Ultimately Lead to Criminal Prosecution and Imprisonment. Are Your Dental Office’s Medical Necessity, Documentation, Coding and Billing Practices Compliant?(October 16, 2019): A Federal District Court Judge recently sentenced a Murfreesboro,...
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 the...
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...
Read More Posts From This CategoryHome Health & Hospice
Home Health Revocation Actions by Medicare are Expanding Around the Country(September 28, 2020): Last September, CMS published a Final Rule titled “Medicare,... [Read more of this review]
Recent Developments in Personal Care and Other Home and Community-Based Services in Medicaid and Medicare(March 23, 2020): Until recently, personal care services, such as home health aides,... [Read more of this review]
OIG Has Identified Common Errors by High-Risk Home Health Agencies. Does Your Home Health Agency Have These Documentation Problems?(September 30, 2019): On September 5, 2019, the Department of Health & Human... [Read more of this review]
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]
Read More Posts From This CategoryRegulatory Issues | Privacy | Other
A Disruptive Conduct Conviction Can Result in a Medicare Exclusion.(September 22, 2020): Since 1981, the Department of Health and Human Services (HHS),... [Read more of this review]
Have You Received a Civil Investigative Demand (CID)? How Should a Health Care Provider or Supplier Respond When Receiving a Civil Investigative Demand?(March 3, 2020): In recent years, Federal prosecutors around the country have increasingly... [Read more of this review]
A Civil Investigative Demand Issued to You or Your Medical Practice is Serious Business. Understand Your Level of Risk Before Responding to the Government’s Investigation(September 17, 2019): The False Claims Act (31 U.S.C. §§ 3729-3733) is the primary... [Read more of this review]
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]
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