Search Results for: medicare suspension

CMS Awards Zone 6 ZPIC Contract to SafeGuard Services

Medicare, Medicaid & Private Payor Updates /

(August 15, 2015): The Centers for Medicare and Medicaid Services (CMS) has awarded the contract for Zone Program Integrity Contractor (ZPIC) services for Zone 6 to SafeGuard Services, LLC. Zone 6 encompasses Maryland, Delaware, Washington, D.C., Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Rhode Island, Vermont, New Hampshire, and Maine. SafeGuard is the current program […]

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Are More Home Health Program Integrity Initiatives on the Horizon?

Home Health & Hospice /

(April 22, 2015): Late last month, the Department of Health and Human Services, Office of Inspector General (HHS-OIG) released its 2015 “Compendium of Unimplemented Recommendations” (Compendium). Published annually, the Compendium sets out the top 25 program integrity issues previously identified by HHS-OIG that are expected to “most positively impact HHS programs in terms of cost

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Hospital Outpatient Dental Services are Being Audited

Dental Audits & Compliance /

(December 4, 2013): Generally, Medicare does not cover hospital outpatient dental services. Under the general exclusion provisions of the Social Security Act, items and services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting the teeth (e.g., preparation of the mouth for dentures or removal of diseased teeth

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Health Integrity Educational Letter Sent to Home Health Agencies in Texas and Oklahoma

Home Health & Hospice /

(November 8, 2013): Health Integrity serves as the Zone Program Integrity Contractor (ZPIC) for Zone 4. This zone is comprised of Texas, Oklahoma, New Mexico and Colorado. Generally, Health Integrity has been assigned responsibility for handling Medicare Part A, Medicare Part B, and Durable Medical Equipment (DME) claims. Health Integrity has been especially aggressive in

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Texas Medical Board Complaints are Serious Business!

Medicare, Medicaid & Private Payor Updates /

(September 20, 2013): Like other physicians around the country, Texas physicians are currently facing increasing pressures to ensure that their medical necessity determinations, coverage assessments, documentation, coding and billing activities meet both Medicare’s requirements and those of private payors. While their duties and responsibilities have continued to increase, reimbursement rates have steadily fallen. Notably, Texas

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Liles Parker Attorney Presented at the West Virginia Physician Summit

Firm News /

(August 26, 2013): Medicare compliance challenges have increased (rather than decreased) with the passage of the Affordable Care Act and the implementation of Electronic Medicare Records (EMR) systems by physicians and other health care providers around the country. Late last week, Robert W. Liles, Managing Partner at Liles Parker, had the privilege of serving as a

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The Texas Medical Board Remains Busy Due to High Number of Complaints Filed in 2012

Medicare, Medicaid & Private Payor Updates /

(February 7, 2013): The Texas Medical Board (Medical Board) was quite busy in 2012. While the number of disciplinary action taken had dropped in some categories, it rose in others. In fact, the overall number of complaints filed with the Medical Board was the 2nd highest in the last decade. The Medical Board’s workload numbers

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Home Health Compliance Risks are a Significant Issue for Texas and Oklahoma Agencies

Home Health & Hospice /

(March 21, 2012): Over the past few weeks, several important events have occurred which should have home health agencies in Texas, Oklahoma and the rest of the country rethinking the adequacy of their existing compliance efforts. The home health compliance practices of many agencies have long been a concern of the Department of Health and

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