"Nationwide Healthcare Lawyers"
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 […]
AMBA Webinar Reading the Tea Leaves – What are the Top Risks Your Practice and / or Third-Party Billing Company will Face in 2024? Tuesday, January 9, 2024 12:00 NOON EST / 11:00 A.M. CST / 9:00 A.M. PST Duration: 60 Minutes Richard Pecore,JD, CMCO Leonard Schneider,JD Join us as we discuss the likely challenges
(January 5, 2016): Now that you have appointed an individual to be responsible for the compliance program and created a compliance committee to help the compliance officer, the focus should turn to basic compliance policies and procedures. If an effective compliance program is like a house with a solid roof to protect the inhabitants from
Basic Compliance Policies and Procedures Read More »
(December 22, 2015): The number of durable medical equipment (DME) audits conducted by Zone Program Integrity Contractors (ZPICs) and Program Safeguard Contractors (PSCs) have surged in recent years. Medicare contractors have gradually increased their scrutiny of DME suppliers’ claims. This has resulted in increased postpayment audits of DME suppliers’ claims and associated overpayment demands made
DME Audits are Back! Are Your Claims Compliant? Read More »
(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
ZPIC Use of the Medicare Fraud Prevention System Read More »
(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
Structural Denial of Due Process in HCQIA Peer Review Proceedings Read More »
(May 5, 2015): As the health care providers and suppliers we represent can easily attest, there are serious problems plaguing the current Medicare appeals process. Rubber-stamp denials by contractors[1] at lower levels of appeal, the failure of Medicare contractors to apply the correct coverage rules and requirements when assessing a claim, and lengthy delays in
The Medicare Appeals Process is Broken Read More »
(March 6, 2015): As we have seen in recent years, Medicaid audits resulting in dental claims False Claims Act liability are increasing around the country. Earlier this week, the U.S. Attorney’s Office, the U.S. Department of Health and Human Services. Office of Inspector General (HHS-OIG), and the Maine Attorney General’s Office announced the settlement of
Dental Claims False Claims Act Liability Read More »
(March 3, 2015): The federal False Claims Act (FCA), 31 U.S.C. §§ 3729 – 3733 is the primary civil enforcement tool utilized by the U.S. Department of Justice (DOJ). Enacted in 1863, this Civil War era statute was passed by Congress in an effort to address the fraudulent acts of government contractors providing goods and
False Claim Act Whistleblower Cases Are Rising Read More »
(February 27, 2015): On February 2, 2015, President Obama released his fiscal year 2016 budget proposal. This latest proposal affects a significant number of Federal health care programs and includes over $1 trillion allocated to the U.S. Department of Health and Human Services (HHS). More than 85 percent of HHS’s budget is devoted to programs
The FY 2016 Budget Proposes Medicare Appeals Process Reforms Read More »
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