Medicare, Medicaid & Private Payor Updates
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. ...
Part I: 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...
DOJ is Aggressively Investigating Allegations of Wrongdoing Related to COVID-19 Fraud and the Current National Emergency(March 27, 2019): We live in trying times. As the coronavirus disease (COVID-19)...
Small Business Administration Releases Express Bridge Loan Pilot Program for COVID-19(March 26, 2020): The Small Business Administration (“SBA”) announced an Express...
Read More Posts From This CategoryDental Audits & Compliance
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...
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...
Read More Posts From This CategoryHome Health & Hospice
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]
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 by... [Read more of this review]
Read More Posts From This CategoryRegulatory Issues | Privacy | Other
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]
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]
Read More Posts From This Category