Regulatory Issues | Privacy | Other

White House Issues Executive Order to Improve the Regulatory Process

Regulatory Issues | Privacy | Other /

(January 18, 2011): Earlier today, President Obama signed an Executive Order and Memoranda to the heads of executive agencies to redesign the regulatory process. Health care is one of the most highly regulated industries in the county. Thus, the manner in which the United States Department of Health and Human Services (“HHS”), the Department of […]

White House Issues Executive Order to Improve the Regulatory Process Read More »

HEAT Investigations of Health Care Fraud in South Texas

Regulatory Issues | Privacy | Other /

(January 6, 2011): Three Houston-area residents, one of whom is a physician, were sentenced to prison on January 4th for their roles in a multi-million dollar durable medical equipment (DME) Medicare fraud scheme. Each of the three defendants were also ordered to pay restitution to the Federal government, in amounts ranging from $29,052 to $1.4

HEAT Investigations of Health Care Fraud in South Texas Read More »

Under Health Care Reform Legislation, Stark Law Whole Hospital and Rural Provider Exceptions are Changing

Compliance, Regulatory Issues | Privacy | Other /

(October 22, 2010): It’s not exactly breaking news to anyone in the hospital industry that the U.S. Congress and the regulators at the Center for Medicare and Medicaid Services seem bent on preventing or eliminating physician referrals to hospitals in which they invest. With the passage of health reform legislation in March of this year,

Under Health Care Reform Legislation, Stark Law Whole Hospital and Rural Provider Exceptions are Changing Read More »

Health Care Reform- The Independent Payment Advisory Board (IPAB) And Its Implications on Health Care Providers

Regulatory Issues | Privacy | Other /

(September 14, 2010): As one of the most controversial provisions in the recently enacted health care reform legislation, Congress created the IPAB – a board that is independent from Congress and the United States Department of Health and Human Services (“HHS”) as a mechanism to control Medicare – and potentially all – health care expenditures.

Health Care Reform- The Independent Payment Advisory Board (IPAB) And Its Implications on Health Care Providers Read More »

Additional Cities will have HEAT Teams in 2011

HEAT Strike Force, Regulatory Issues | Privacy | Other /

(August 27, 2010): Additional cities will be getting Medicare fraud HEAT teams. Yesterday, Attorney General Eric Holder and U. S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius conducted the second of a planned series of “Regional Health Care Fraud Prevention Summits.” In addition to these agency heads, participants learned of current and

Additional Cities will have HEAT Teams in 2011 Read More »

What Can Cities Do About Dangerous Buildings?

Regulatory Issues | Privacy | Other /

(June 25, 2010): Cities have the authority, usually provided by State statute, to regulate dangerous and substandard buildings and structures. In Texas, a City has to pass an ordinance to activate its ability to regulate dangerous buildings and structures. See TEX. LOC. GVT CODE § 214 Subchapter A. Before taking action against a dangerous building,

What Can Cities Do About Dangerous Buildings? Read More »

Don’t Take ZPIC Extrapolation Calculations at Face Value

Regulatory Issues | Privacy | Other /

(July 14, 2010): Imagine a Zone Program Integrity Contractor (ZPIC) handing you a claim analysis rife with alleged errors, an indecipherable list of statistical formulae, and an extrapolated recovery demand that will cripple your practice or clinic. What steps should you take to analyze their work? Based on our experience, providers can and should carefully

Don’t Take ZPIC Extrapolation Calculations at Face Value Read More »