Health Law Provider Updates

An Overview of Administrative Rheumatology Audits / Adverse Actions AND Civil / Criminal Enforcement Actions

(May 20, 2018):  It’s been a rough week for at least one Texas rheumatologist. ... 

Expect an Increase in Audits of Chiropractic Services!

(April 16, 2018): Chiropractors around the country are again finding their... 

CBRs for Spinal Orthoses (CBR201803): What Do You Need to Know?

(April 12, 2018): The Centers for Medicare & Medicaid Services (CMS) utilizes... 

ZPIC Audits / UPIC Audits: The Impact of Transmittal 768 on the Medicare Appeals Process Timeline.

(April 12, 2018): A big concern with the Medicare appeals process is the ghastly... 

Medicare Advantage Plans May Soon Offer Personal Care Services

(April 10, 2018):  On April 2, the Centers for Medicare and Medicaid Services (CMS)... 

The PSAVE Pilot Program: Should You Self-Audit Your Medicare Claims?

(April 2, 2018):  Our nation’s demographics are changing.  In less than... 

Veterans Administration and CMS Announce Partnership to Address Fraud Prevention

(January 25, 2018): On January 23rd, the Veteran Administration (VA) and the Centers... 

Personal Care Services Are Under the Government’s Microscope

(January 22, 2018): The Department of Health and Human Services, Office of... 

Revocation of Your Medicare Billing Privileges.

The revocation of your Medicare billing privileges can subject your practice... 

UPIC / ZPIC Referrals to State Boards, Societies, Surveyors and QIOs

(November 29, 2017):  The Medicare and Medicaid programs are managed by the... 

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Dental Audits & Compliance

Dental Claims Audits are on the Rise

Both Medicaid and private payor dental claims audits are increasing around... 

Dental Fraud: Dentist Faces 3,974 Years in Prison if Convicted!

(November 30, 2017):  Earlier this year, Attorney General Jeff Sessions announced... 

Medicaid Dental Audits of IV Sedation Services

(June 16, 2017):  Under the Social Security Act, states are required to operate... 

Delta Dental Audits are Ongoing Around the Country. Are You Prepared?

(May 15, 2017):  Over the last decade, both state and federal law enforcement... 

Medicaid Dentist Eligibility Audits are Ongoing Around the Country

(January 9, 2017):  A recent report of the New York State agency that administers... 

Dental Practice Audits are on the Rise — Protect your Interests!

(October 11, 2016): More than 45 million children receive government-funded... 

More Texas Medicaid Dental Audits Are Coming in 2017!

(August 23, 2016): During 2014, the Texas Health Human Services Commission’s... 

Exclusion Screening / OIG Screening and Background Checks in Dental Practices

(March 31, 2016):  Many of the dental practices around the country do not... 

OIG Finds Significant Medicare Dental Overpayments Made to Hospitals

(October 27, 2015): Late this summer, the Office of Inspector General for the U.S.... 

Dental Claims False Claims Act Liability

(March 6, 2015): As we have seen in recent years, Medicaid audits resulting... 

Medicaid Dental Audits: Exclusion Screening Issues

(January 22, 2015): Medicaid dental audits have greatly expanded over the past... 

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Medicare Overpayments

Seven Elements of a Payable Claim are an Essential Tool When Preparing for a ZPIC Audit

(September 21, 2012):  Each year, our attorneys and paralegals review and... [Read more of this review]

AdQIC: A Brief Refresher on the Role This Contractor Plays.

(June 15, 2012): If you have ever been involved in a Medicare postpayment audit,... [Read more of this review]

100 Involved in Health Care Fraud Arrests

Update (May 3): In total, 107 individuals were charged yesterday in connection... [Read more of this review]

Lose Your Appeal at Reconsideration? Consider an ALJ Hearing

(June 18, 2011): As a review of the last several quarters of Medicare appeals... [Read more of this review]

The Medicare Administrative Appeal Process

(March 25, 2011): Zone Program Integrity Contractors (ZPICs) have established... [Read more of this review]

Health Data Insights Begins Medical Necessity Reviews

(August 30, 2010): Health Data Insights (HDI), the Centers for Medicare &... [Read more of this review]

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Regulatory Issues | Privacy

Sexual Harassment: Cases Against Texas Physicians in 2017

(January 26, 2018): From Churches to Congress, sexual harassment and assault... [Read more of this review]

Maryland Limits on Opioid Prescriptions

(June 30, 2017):  In March 2016, the Centers for Disease Control and Prevention... [Read more of this review]

Cell Tower Ground Lease Renewals and Purchases

(September 15, 2015): A landowner/ground lessor considering a renewal or easement... [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... [Read more of this review]

Peddling and Soliciting, Municipal Regulations These Issues Can be Complex. Is Your City Clear on These Points?

(January 8, 2013):  As a general rule cities can regulate hawking, canvassing,... [Read more of this review]

What is Civil Fraud?

(Updated June 18, 2018):  According to the Association of Certified Fraud... [Read more of this review]

Guide to Efficient Business Transactions: Part III

(July 6, 2012):  This article is a continuation of our discussion on how a... [Read more of this review]

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