Firm News

Balloon Sinuplasty Fraud / Balloon Dilation Fraud Prosecutions are Increasing Around the Country

(May 25, 2022): In recent years, federal regulators have initiated a significant number of audits and investigations examining the improper billing of claims for balloon sinuplasty / balloon dilation procedures by Otolaryngologists (commonly referred to as Ear, Nose and Throat (ENT) physicians. Depending on the specific facts in each case, the improper billing of balloon …

Balloon Sinuplasty Fraud / Balloon Dilation Fraud Prosecutions are Increasing Around the Country Read More »

Prepayment Reviews and Audits of Medicare Claims are Ongoing. Are Your Claims Being Audited?

(January 19, 2021):  As you will recall, on March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) suspended most Medicare audits and reviews due to the COVID-19 national emergency.  In early August, CMS instructed its contractors to resume their prepayment and postpayment audit activities. Over the last six months, we have seen a …

Prepayment Reviews and Audits of Medicare Claims are Ongoing. Are Your Claims Being Audited? Read More »

audits-of-respiratory-lilesparker

Audits of Respiratory (CPT Code 87633) / Gastro (CPT Code 87507) Panels are Ongoing.

(January 3, 2021):  In recent months, we have seen a significant rise in the number of Medicare and Medicaid audits focusing on the medical necessity of certain outpatient Respiratory Viral Panels (CPT Code 87633) and Gastrointestinal Pathogen Panels (CPT Code 87507).  Unfortunately, many of these audits seem to be merely the latest example where payors …

Audits of Respiratory (CPT Code 87633) / Gastro (CPT Code 87507) Panels are Ongoing. Read More »

A Look Back at Hospice Audits and Prosecutions in 2020 — Are You Ready for 2021?

(December 28, 2020):  Let’s face it, we are all glad to have 2020 behind us.  From an enforcement standpoint, COVID-19 greatly impeded the Federal government’s ability to investigate and prosecute civil and criminal violations of law.  The numbers speak for themselves.  Between February 2020 and April 2020, new criminal prosecutions had dropped by 80%. [1] …

A Look Back at Hospice Audits and Prosecutions in 2020 — Are You Ready for 2021? Read More »

It’s Time for CMS and Congress to Review Outdated Medicare and Medicaid Provisions

(November 23, 2016): Michael Cook, co-chair of the Health Care Group, has an article published in the October issue of the American Health Lawyers Association Journal of Health Law & Life Sciences entitled “It’s Time for CMS and Congress to Review Outdated Medicare and Medicaid Provisions.” The article discusses the fact that given the dramatic …

It’s Time for CMS and Congress to Review Outdated Medicare and Medicaid Provisions Read More »

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

(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 …

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

Liles Parker Attorney Presented at the West Virginia Physician Summit

(August 26, 2013): Medicare compliance challenges have increased (rather than decreased) with the passage of the Affordable Care Act and the implementation of Electronic Medicare Records (EMR) systems by physicians and other health care providers around the country. Late last week, Robert W. Liles, Managing Partner at Liles Parker, had the privilege of serving as a …

Liles Parker Attorney Presented at the West Virginia Physician Summit Read More »

HBMA Journal Includes Cloud Computing Article by Liles Parker Attorney in its Latest Edition

(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 …

HBMA Journal Includes Cloud Computing Article by Liles Parker Attorney in its Latest Edition Read More »