Search Results for: stark self-referral

Stark Self-Referral Prohibitions

The Ethics in Patient Referrals Act of 1989, 42 U.S.C. § 1395nn, otherwise referred to as “Stark”[1] prohibits a physician from referring Medicare or Medicaid program patients for “designated health services” (DHS) to an entity with which the physician or an immediate family member has a prohibited financial relationship, unless one of the statutory or […]

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OIG Provider Self-Disclosure Considerations

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The Department of Health and Human Services (HHS), Office of Inspector General (OIG) has historically emphasized the importance of “square dealing” with government supported health care programs and urged health care providers to adopt effective practices and procedures that are designed to promote compliance with applicable statutory and regulatory requirements and detect and prevent fraud.

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Preparing for a UPIC Audit? Examine These Eight Claim Elements

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(Updated January 9, 2021): Each year, our attorneys and paralegals review and assess literally thousands of Medicare claims which have been audited (and denied) by Unified Program Integrity Contractors (UPICs) and other contractors working for the Centers for Medicare and Medicaid Services (CMS).  Are you preparing for a UPIC audit?  If your Medicare or Medicaid

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