Search Results for: "Mock" audits

Conducting a Gap Analysis / Mock Audit: An Essential Compliance Tool for Your Practice

(November 15, 2011): Understandably, health care providers have grown weary of government audits, malpractice issues, peer reviews and private payor assessments.  In an effort to reduce their potential liability, many providers are now regularly utilizing Gap Analyses / Mock Audits to test their preparedness for audit.  In doing so, they have been able to identify and correct potential problems before they …

Conducting a Gap Analysis / Mock Audit: An Essential Compliance Tool for Your Practice Read More »

Areas of Practice

Health Care Law Liles Parker attorneys have the litigation experience, health care regulatory knowledge, and counseling skills necessary to efficiently resolve health care issues at the lowest possible level, before they escalate into a more significant problem Learn More Unified Program Integrity Contractor (UPIC) Audits HIPAA Audits and Compliance False Claims Act Matters and Cases …

Areas of Practice Read More »

Regulatory & Compliance Related Services

“Gap” Analyses of Health Care Practices Compliance Plan Creation, Periodic Review, and Implementation Compliance Training for Clinical and Administrative Staff “Mock” Audits of Claims and Services Business Practice Analysis and Issuance of Formal Opinion Letters Independent Review Organization (IRO) services reporting to the Department of Health and Human Services, Office of Inspector General in connection …

Regulatory & Compliance Related Services Read More »

The OIG Identifies Substantial SNF Medicare Overpayments

(November 18, 2012): A recent report issued by the Department of Health and Human Services, Office of Inspector General (OIG), OEI-02-09-00200 (Report),  found substantial errors in payments made by Medicare to skilled nursing facilities (SNFs) for FY 2009.  The Report also found substantial errors in SNF reporting on the Minimum Data Set (MDS) forms.  Specifically, the …

The OIG Identifies Substantial SNF Medicare Overpayments Read More »

100 Involved in Health Care Fraud Arrests

Update (May 3): In total, 107 individuals were charged yesterday in connection with a health care fraud scheme comprising $452 million in false billing. 91 of the accused have been arrested and are in custody. (May 2, 2012): News outlets are reporting that approximately 100 people have been arrested and charged with one or more health …

100 Involved in Health Care Fraud Arrests Read More »

OMHA Changes ALJ Hearing Case System

(March 2, 2012):  Likely recognizing the enormous disparity in Administrative Law Judge (ALJ) hearing workloads for its various Field Offices, the Office of Medicare Hearings and Appeals (OMHA) recently switched to a Central Docketing System for all pending and new appeals. Under this new system, all ALJ hearing requests will be sent to OMHA’s Central Office …

OMHA Changes ALJ Hearing Case System Read More »

Georgia Prepayment Reviews are Being Conducted by AdvanceMed

(February 29, 2012): In the past few weeks, AdvanceMed Corporation, the Zone Program Integrity Contractor (ZPIC) for Regions II and V (covering the Northwestern and Southeastern portions of the United States, respectively), appears to have significantly expanded the number of Georgia prepayment reviews it is conducting.  More specifically, AdvanceMed appears to be focusing on hospices, psychiatric services …

Georgia Prepayment Reviews are Being Conducted by AdvanceMed Read More »