"Nationwide Healthcare Lawyers"
(November 20, 2023): Medicare, Medicaid, and most private insurance plans cover hospice care and related services. To be eligible for hospice care,1 a patient must be certified as terminally ill and have a life expectancy of six months or less. In recent years, the hospice industry has exponentially grown, and the number of Federal, State …
Hospice Audit and Investigative Actions are Expected to Rise in 2024 Read More »
(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 …
(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 …
(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 »
It is official! Associate Attorney Ashley Morgan has been named a” Super Lawyer — Rising Star ” Additionally, she passed the Certified Professional Coder exam and is now a Certified Coder!
(January 2, 2018): Congratulations to our very own Michael Cook who has been appointed to serve on the Virginia Medicaid Policy Council for Health and Human Resources. In this role, The Council’s role is to provide recommendations on policy issues involving the programs operated by the Department of Health and Human Resources as part of the transition.
(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Health Lawyers Association Journal of Health Law & Life Sciences entitled “It’s Time for CMS and Congress to Review Outdated Medicare and Medicaid Provisions.”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 »
(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 »
(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 »
(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 …
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