Search Results for: Special Investigations Unit

State and Federal Hospice Audit and Investigation Efforts are Expanding in 2022

Home Health & Hospice /

(May 12, 2022): Hospice agencies are again the focus of both state and federal investigators and prosecutors around the country. The number of hospice audits and investigations at both the state and federal levels have risen in 2022. This isn’t surprising given the ever-expanding level of beneficiary participation and cost of Medicare’s hospice benefit program. […]

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A Review of Dental Enforcement in 2021 and a Look at What Dentists Should Expect in 2022

Dental Audits & Compliance /

(February 22, 2022): The treatment and business challenges presented by COVID-19 over the last two years have been especially demanding on dentists and their practices. Between the lockdowns and a hesitancy by many individuals to schedule non-emergent dental care, many dental practices have found it tougher than ever to maintain previous levels of profitability. Not

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Chiropractor Owned Multidisciplinary Practices are at a Higher Risk of Audit

Medicare, Medicaid & Private Payor Updates /

(January 13, 2021):  Over the last few years, we have noted a significant increase in the number of audits initiated against Chiropractor owned multidisciplinary practices.  Typically, these integrated medical practices and clinics employ at least one Chiropractor (typically in an ownership or managerial capacity), along with multiple Doctors of Medicine (MDs), Doctors of Osteopathy (DOs).

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Pierce the Corporate Veil — Are You Personally Liable for a UPIC Overpayment?

Regulatory Issues | Privacy | Other /

(Updated January 9, 2021): Owners of healthcare companies often wonder whether the government can pierce the corporate veil and try to hold the owners personally liable for overpayment claims when facing a program integrity audit by a Unified Program Integrity Contractor (UPIC). [1] This rarely happens, but assuming that a provider does not prevail in

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Ashley Morgan, J.D.

Ashley Morgan is a partner at Lliles Parker. She focuses her practice on regulatory health care compliance matters, fraud and abuse, and reimbursement issues. Ms. Morgan represents health care providers across the country in connection with a wide variety of health law issues including coverage disputes, documentation concerns, compliance, medical board complaints, and exclusion /

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OIG Exclusion Actions — Mandatory and Permissive Exclusion Authorities

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The most severe administrative sanctions available under the Social Security Act stems from the authority of the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) [1] to “exclude” individuals and entities from participating in Federal health care programs. Indeed, an OIG Exclusion [2] imposed by the OIG is

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Healthcare Law Representation

Liles Parker attorneys have decades of experience practicing health care law.  Several of our attorneys served as Federal prosecutors and held significant positions at the U.S. Department of Justice.  Our health care transactional and regulatory attorneys have the knowledge and counseling skills necessary to efficiently resolve your health care business issues at the lowest possible

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HIPAA Privacy Rule / HIPAA Security Rule / HIPAA Enforcement Rule — Audits by OCR

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The impact of the passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) has been enormous.  Covered entities, business associates and subcontractor business associates are required by law to fully comply with HIPAA’s requirements.  Should they fail to meet their statutory obligations, they are subject to significant administrative penalties, civil enforcement, and

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AbilityOne OIG Audits are Ramping-Up! Is Your Nonprofit Agency Ready for an Audit?

Regulatory Issues | Privacy | Other /

(November 11, 2020):  If you run a nonprofit company that contracts with the federal government through the AbilityOne Program, then you should be aware that inadequate compliance policies could put your nonprofit in danger of facing allegations of waste, fraud, abuse, and mismanagement, onerous audits and investigations, and even civil liability.   Under the AbilityOne Program,

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