Ashley Morgan

Liles Parker’s Michael Cook Appointed to Virginia Board of Medical Assistance Services

Firm News /

(March 20. 2015): Liles Parker is proud to announce that Governor Terry McAuliffe (VA) has appointed Michael Cook, co-chair of our health care group, to a four-year term as a member of the Virginia Board of Medical Assistance Services. The Board is established pursuant to Virginia statute to oversee the Medicaid program, including the development […]

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Individual Liability for Medicare Overpayment Claims

Medicare, Medicaid & Private Payor Updates /

(February 24, 2015): Medicare recently finalized regulations allowing enrollment as a Medicare provider to be denied if any owner or control person of the enrolling provider is affiliated with another provider which owes money to Medicare. These regulations are based on sections of the 2010 Affordable Care Act (ACA). They provide CMS an indirect means

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HIPAA Security Risk Assessments are Essential

Medicare, Medicaid & Private Payor Updates /

(September 29, 2014) In the last article, we discussed the importance of conducting HIPAA security risk assessments, as part of your obligations under the HIPAA Security rules. The importance of promptly conducting a risk analysis if it has not yet done cannot be overestimated, as the HHS Office for Civil Rights (OCR) has now announced

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Peer Review: How HCQIA Due Process is a Fiction

Medicare, Medicaid & Private Payor Updates /

(August 31, 2014): The Healthcare Quality Improvement Act of 1986[1] (“HCQIA”, generally pronounced “Hick Kwah”), affords peer-reviewing bodies and their members legal immunity from liability from suits by the physicians they discipline, so long as their peer-review processes include certain due process rights for the accused physician. Unfortunately, the provider peer review process is irrevocably

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A HIPAA Risk Assessment is Essential to Avoid Liability

Medicare, Medicaid & Private Payor Updates /

(August 23, 2014): Almost all health care providers and suppliers qualify as a “covered entity” under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Together with the “business associates” with whom they work, these entities are responsible for ensuring that any protected health information (PHI) under their control has been properly secured and

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Medicare ALJ Appeals of Denied Home Health Claims

Home Health & Hospice /

(February 11, 2014): Has a Zone Program Integrity Contractor (ZPIC) denied your home health claims? If you believe that these denials are unwarranted, your home health agency (HHA) may challenge the denials through Medicare’s administrative appeals process. Medicare’s appeals process provides five levels of appeal. The first four levels of appeal are before different administrative

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Is Your Dental Practice Prepared to Undergo a Medicaid Dental Audit?

Dental Audits & Compliance /

(November 25, 2013): The link between oral health and overall health has been increasingly acknowledged over the years. Emphasis has been placed on children’s oral health in particular. In fact, the Children’s Health Insurance Program Re-authorization Act of 2009 (CHIPRA) mandates that “child health assistance provided to a targeted low-income child shall include coverage of

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Texas Medical Board Complaints are Serious Business!

Medicare, Medicaid & Private Payor Updates /

(September 20, 2013): Like other physicians around the country, Texas physicians are currently facing increasing pressures to ensure that their medical necessity determinations, coverage assessments, documentation, coding and billing activities meet both Medicare’s requirements and those of private payors. While their duties and responsibilities have continued to increase, reimbursement rates have steadily fallen. Notably, Texas

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