Regulatory Issues | Privacy | Other

A Negative NPDB Report Can End Your Career— Know Your Rights

Regulatory Issues | Privacy | Other /

(July 15, 2026): For health care practitioners, providers, and suppliers, the National Practitioner Data Bank (NPDB) represents one of the most significant and least understood forces in their professional lives. What began as an effort by Congress to track incompetent physicians has evolved into a massive, permanent repository of medical malpractice payments, disciplinary actions, and […]

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Staying Ahead of the Surge in Medicare Revocation Actions - Featured Image - Liles Parker

Fraud Risks Facing Recovery Residences: A Guide for Owners & Managers

Regulatory Issues | Privacy | Other /

(June 1, 2026): Recovery residences[1] (sometimes referred to as sober homes) play a significant role in supporting individuals with substance use disorders who need stable, supportive housing. But the same features that make recovery residences important to the continuum of care also create substantial legal exposure for owners, operators, investors, and managers. These risks do

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SB 1318 & Physician Noncompetes in Texas

Regulatory Issues | Privacy | Other /

(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

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Audits of Semaglutide and Other GLP-1 Claims are Increasing

Prescriber Risks Ordering Semaglutide, Tirzepatide and Other Compounded GLP-1 Medications

Regulatory Issues | Privacy | Other /

(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,

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The OPM Debarment Action on Health care Providers - Liles Parker - Dec 2023

The OPM Debarment Process – Responding to an FEHBP Debarment or Suspension Action in 2024

Regulatory Issues | Privacy | Other /

(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

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AI in medical billing- Liles Parker - October 2023

AI in Medical Billing: A Benefit or a Compliance Risk?

Regulatory Issues | Privacy | Other /

(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

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TPE Audits: The Process & Expected Targets in 2023

Regulatory Issues | Privacy | Other /

(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

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Civil Investigative Demands (CIDs) & Collateral Enforcement Risks: A Review

Regulatory Issues | Privacy | Other /

(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

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laws regulation changes affect billing agreement - Liles Parker

Ever-Changing Federal and State Laws and Regulations are Transforming Third-Party Billing Contracts

Regulatory Issues | Privacy | Other /

(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

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The OIG Exclusion List of Individuals and Entities is Growing. What Steps are You Taking to Avoid Hiring or Contracting with an Excluded Individual or Entity?

Compliance, Medicare, Medicaid & Private Payor Updates, Regulatory Issues | Privacy | Other /

(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

The OIG Exclusion List of Individuals and Entities is Growing. What Steps are You Taking to Avoid Hiring or Contracting with an Excluded Individual or Entity? Read More »