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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
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
(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
OIG Finds Significant Medicare Dental Overpayments Made to Hospitals Read More »
(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
Medicare Ophthalmology Audits: Is Your Practice Ready? 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 »
(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
2014 HCFAC Report — $27.8 Billion Recovered for Medicare Read More »
(February 24, 2015): Medicare recently finalized regulations allowing enrollment as a Medicare provider to be denied if any owner or control person of the enrolling provider is affiliated with another provider which owes money to Medicare. These regulations are based on sections of the 2010 Affordable Care Act (ACA). They provide CMS an indirect means
Individual Liability for Medicare Overpayment Claims Read More »
(August 31, 2014): The Healthcare Quality Improvement Act of 1986[1] (“HCQIA”, generally pronounced “Hick Kwah”), 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. Unfortunately, the provider peer review process is irrevocably
Peer Review: How HCQIA Due Process is a Fiction Read More »
(February 11, 2014): Has a Zone Program Integrity Contractor (ZPIC) denied your home health claims? If you believe that these denials are unwarranted, your home health agency (HHA) may challenge the denials through Medicare’s administrative appeals process. Medicare’s appeals process provides five levels of appeal. The first four levels of appeal are before different administrative
Medicare ALJ Appeals of Denied Home Health Claims Read More »
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