Medicare, Medicaid & Private Payor Updates
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...
Transcranial Magnetic Stimulation Claims Audits by Medicare MACs and UPICs are Underway. Are Your CPT 90868 Claims Compliant?(July 16, 2018): Do you provide Transcranial Magnetic Stimulation care...
Is Your Urogynecology, OB/GYN or Multidisciplinary Practice Prepared for a Medicare Biofeedback Claims Audit or a Pelvic Floor Therapy Claims Audit?(July 12, 2018): While no medical specialty has completely avoided the scrutiny...
CMS has Confirmed the Coverage of Personal Care Services by Medicare Advantage Plans Starting 2019.(June 26, 2018): The coverage of personal care services by Medicare has been...
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...
Read More Posts From This CategoryDental Audits & Compliance
Mobile Dentistry in Texas – An Overview of Regulatory Risk Areas to be Considered(December 7, 2018): Each state sets their own licensure requirements, rules...
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...
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....
Read More Posts From This CategoryHome Health & Hospice
Home Health Providers Under the Microscope — The Review Choice Demonstration Project is Here(October 4, 2018): Last week, the Centers for Medicare & Medicaid Services... [Read more of this review]
Personal Care Services Are Under the Government’s Microscope(January 22, 2018): The Department of Health and Human Services, Office of... [Read more of this review]
Medicare Home Services (CPT® codes 99341-99350) are Being Audited(June 20, 2017): As the Department of Health and Human Services (HHS), Office... [Read more of this review]
Home Health Final Rule Creates New Exclusion Screening Obligation(March 29, 2017): The Centers for Medicare and Medicaid Services (CMS) has... [Read more of this review]
Home Health: Pre-Claim Review Demonstration Project(January 9, 2017): As the Centers for Medicare and Medicaid Services (CMS)... [Read more of this review]
Responding to OIG Home Health Audits(November 23, 2016): The Office of Audit Services, Office of Inspector General... [Read more of this review]
Read More Posts From This CategoryRegulatory Issues | Privacy | Other
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... [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]
Pierce the Corporate Veil-Can Healthcare Owners Be Personally Liable?(March 13, 2015): Owners of healthcare companies often wonder whether the... [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]
The HIPAA / HITECH Omnibus Final Rule is Here! Is Your Health Care Organization Complying with the Rules?(September 23, 2013): Effective today, all covered entities and business... [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]
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