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Responding to a State Nursing Board Complaint

Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs), such as Nurse Practitioners, Clinical Nurse Specialists, Nurse Anesthetists, or Nurse Midwives are regulated in most states by their respective State Board of Nursing (Nursing Board).  This article is intended to provide a general overview of the complaint process and address issues that you may face […]

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ZPIC Audit Responsibilities Have Been Transferred to UPICs Around the Country

(Updated January 4, 2021): In April 2014, the Centers for Medicare and Medicaid Services (CMS) issued an an Umbrella Statement of Work for the the awarding of program integrity contracts by new organizations known as “Unified Program Integrity Contractors” (UPICs). UPICs took over the responsibilities of Zone Program Integrity Contractors (ZPICs) and Medicaid Integrity Contractors

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Are you Ready for the Next Round of CMS Revalidation?

(March 17, 2017): The Centers for Medicare and Medicaid Services (CMS) recently announced that it will be initiating its next round of CMS revalidation requests to all Medicare enrolled providers and suppliers. Current law and regulations require providers and suppliers to revalidate their enrollment with Medicare every five years (every three years for DME suppliers).

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Webinars Playback

2020-2021 TAHCH Webinars   Wednesday, January 6th, 2020, 1 p.m. EST / Noon CST / 10:00 a.m. PST COVID-19 Employee Health Issues for Home Health Hospice Agencies Despite the approval, release and distribution of a coronavirus vaccine, the numbers of available doses are still not sufficient to vaccinate all at-risk populations and individuals.  Thus, home

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TAHCH Webinars

Liles Parker PLLC is pleased to announce its upcoming Webinar Wednesday series in partnership with the Texas Association for Home Care & Hospice (TAHCH). Starting January 2016, Liles Parker attorneys will provide a monthly hour-long webinar on pertinent compliance issues facing home health, hospice, and personal care agencies. Topics address wide array of matters including:

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OIG Finds Significant Medicare Dental Overpayments Made to Hospitals

(October 27, 2015): Late this summer, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) announced that more than $2 million in payments to dental providers for hospital outpatient dental services would have to be reimbursed to the federal government for failure to comply with Medicare program requirements. The

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Medicare Ophthalmology Audits: Is Your Practice Ready?

(October 26, 2015): Last month, the Department of Health and Human Services (HHS), Office of Inspector General (OIG) released a study entitled “Questionable Billing for Medicare Ophthalmology Services.” As the study findings reflect, the OIG concluded that for the year 2012, approximately $171 million of the Medicare payments made that year for ophthalmology services were

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ZPIC Use of the Medicare Fraud Prevention System

(October 20, 2015): As required by the Small Business Jobs Act of 2010, the Department of Health and Human Services (HHS) is required to conduct a review of payments for Medicare fee-for-service claims by using “predictive analytics technologies” every three years. Predictive analytics technologies employ a variety of predictive models and statistical analysts for detection

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Structural Denial of Due Process in HCQIA Peer Review Proceedings

(October 12, 2015): The Federal HCQIA peer review statute affords peer-reviewing bodies and their members legal immunity from liability from suits by the physicians they discipline, so long as their peer-review processes include certain due process rights for the accused physician. These due process rights are expressed as a right to a hearing, and are

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2014 HCFAC Report — $27.8 Billion Recovered for Medicare

(March 23, 2015): Last week, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced that they had recovered more than $27.8 billion to the Medicare Trust Fund due to the efforts of the Health Care Fraud and Abuse Control Program (HCFAC). As set out in the 2014 HCFAC Report, in

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