"Nationwide Healthcare Lawyers"
(July 17, 2025): The Texas Legislature recently passed and Texas Governor Greg Abbott signed SB 1318,[1] a new act amending Section 15.50 of the Texas Business and Commerce Code relating to physician noncompete clauses, and adding a new Section 15.501. The new law imposes explicit limits on the period and geographic region for physician non-compete […]
SB 1318 & Physician Noncompetes in Texas Read More »
(October 24, 2024): Semaglutide, tirzepatide and a slate of other GLP-1 receptor agonist medications have dominated weight loss headlines in recent years. Not surprisingly, many weight loss providers and clinics have refocused their approaches, incorporating these drugs into patient treatment regimens. Unfortunately, the popularity of these drugs has led to a variety of bad practices,
(December 20, 2023): Most health care providers and suppliers are familiar with the fact that as a participating provider in the Medicare and / or Medicaid programs, certain criminal convictions, adverse licensure actions, and various types of prohibited conduct may subject the provider to exclusion from participation in Federal health care programs[1] by the Department
(October 10, 2023): In terms of revenues and expenses, health care providers and suppliers have repeatedly faced two unfortunate realities: (1) Reimbursement rates are shrinking, and (2) they are constantly being saddled with additional unfunded mandates (for example, HIPAA compliance, OSHA requirements, compliance obligations, etc. Coupled with ordinary practice expenses, many health care providers are
AI in Medical Billing: A Benefit or a Compliance Risk? Read More »
(January 26, 2023): Since the inception of the pilot program in 2015, the Targeted Probe and Educate Audit (TPE audit) program has effectively been a double-edged sword for most providers. On the positive side, it has served as an educational tool that providers can use to better ensure that their medical necessity, documentation, coding and
TPE Audits: The Process & Expected Targets in 2023 Read More »
(October 12, 2022): The False Claims Act is the primary civil enforcement tool utilized by our government today. In Fiscal Year (FY) 2021, the U.S. Department of Justice (DOJ) won or negotiated over $5.6 billion in False Claims Act (FCA)[1] settlements and judgments. Of that amount, more than $5 billion [2] resulted from matters involving
Civil Investigative Demands (CIDs) & Collateral Enforcement Risks: A Review Read More »
(July 28, 2022): The business side of medicine has changed considerably over the last decade. Health care laws, regulations, and administrative policies are constantly evolving. A number of these changes have impacted health care practices, billing companies, and the third-party billing contracts executed between these parties. From its earliest beginnings, the majority of third-party billing
(March 17, 2022): Over the last few months (from mid-November 2021 through mid-March 2022), the number of excluded individuals and entities on the Department of Health and Human Services, Office of Inspector General’s (OIG’s) List of Excluded Individuals/Entities (LEIE) has grown by approximately 15%. According to our friends at Exclusion Screening,[1] this rapid expansion of
(January 24, 2022): In a 5-4 decision, the US Supreme Court issued a ruling on January 13, 2022 staying the injunctions preventing the implementation of CMS’ Vaccine Mandate in 24 states.[1] As a result, Medicare and Medicaid providers[2] subject to the CMS Vaccine Mandate interim final rule in those states must quickly take steps to
US Supreme Court Lifts Injunctions of CMS Vaccine Mandate Read More »
(October 21, 2021): The False Claims Act [1] remains the primary civil enforcement tool utilized by the U.S. Department of Justice (DOJ). While the results of Fiscal Year (FY) 2021 have not yet been published, settlements and judgements in FY 2020 exceeded $2.2 billion. Of this total, $1.8 billion were related to the health care
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