Medicare, Medicaid & Private Payor Updates
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...
Audits of Telehealth Services are Increasing. Do Your Telehealth Services Meet Applicable Requirements?(December 21, 2018): The use of “telehealth” technologies to diagnose...
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...
Read More Posts From This CategoryDental Audits & Compliance
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...
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...
Read More Posts From This CategoryHome Health & Hospice
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]
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]
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... [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... [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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