"Nationwide Healthcare Lawyers"
(February 5, 2013): A “back orthosis” is type of brace that is placed on the outside of a patient’s body and is intended to help stabilize a patient’s spine. In some instances, it is used to limit motion. In others, it is used to address a structural deformity which may exist (such as scoliosis). There […]
DME Claims Audits of Back Braces by OIG, MACs, and ZPICs are Likely to Further Intensify Read More »
(January 30, 2013): Are the home health services you are currently providing compliant with applicable coverage, documentation and medical necessity requirements? Have you carefully reviewed your current caseload to ensure that each patient does, in fact, qualify as “homebound.” Do you have an effective Compliance Plan in place to assist you with your efforts? Now,
Home Health Prepayment Reviews are Increasing. Is Your Documentation Compliant? Read More »
(January 18, 2013): Specialty dental practices around the country are receiving audit letters from “Zone Program Integrity Contractors” (ZPICs), contractors working for the Centers for Medicare and Medicaid Services (CMS). This latest audit focus by ZPICs is rather surprising in light of the fact that very few dental procedures qualify for Medicare coverage and payment.
(January 14, 2013): In recent years, we have represented physicians and a range of other health care providers in administrative litigation over “exclusion” related enforcement actions. One of the most severe sanctions available under the Social Security Act stems from the authority to exclude individuals and entities from participation in federal health care programs. Medicare
(December 31, 2012): Over the last year, many dentists, orthodontists and oral surgeons around the country who participate in federal health care benefits programs such as Medicare and Medicaid have found themselves accused of a “credible allegation of fraud,” levied by federal / state investigators or agents contracted to audit dental providers on behalf of
(December 30, 2012): Generally speaking, from the standpoint of a dental practice, “Cloud Computing” involves the use of an offsite server to store and access medical records, maintain patient information and or practice business records (such as coding and billing information). Cloud Service Providers (CSP) offer various services to dental practices. In most instances, the
(December 4, 2012): This month, the Healthcare Billing & Management Association’s (HBMA) Journal, Billing, features an HBMA Journal article written by Robert W. Liles, Managing Partner at the firm. Entitled “Be Careful Before Moving to Cloud Computing: A Contrarian View of the Inevitable,” the article tackles many of the current risks associated with the use
(November 19, 2012): Zone Program Integrity Contractors, better known also as “ZPICs,” are continuing to focus on home health agencies (HHAs), hospice providers, and DME companies as the subject of their Medicare audits. Based on input from both the Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS), ZPIC audits
ZPIC Home Health Audits are Slated for the Future Read More »
(November 12, 2012): The AHA Supports the Medicare Audit Improvement Act of 2012. Is this Legislation Going to Help Physicians or Not? On October 16, 2012, a new bill was introduced by Representative Sam Graves (R-MO) entitled the “Medicare Audit Improvement Act of 2012”. This legislation was immediately supported by the American Hospital Association (AHA),
(November 2, 2012): As we recently discussed before the East Coast arrival of Hurricane Sandy, Social Security Act Section 1135 Waivers may ultimately be available for healthcare providers in affected areas of New York, New Jersey, Delaware, New England, and surrounding states. 1135 Waivers exist to temporarily waive billing and participation requirements for healthcare providers
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