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Posts by category
- Category: Dental Law Articles
- Medicaid Dental Audits of Intravenous (IV) Sedation Services.
- Delta Dental is Conducting Dental Claims Audits Around the Country.
- Medicaid Dental Audits are Examining Dentist Eligibility to Provide Treatment
- Dental Claims Audits on the Rise — How to Protect your Practice
- More Texas Medicaid Dental Audits Are Coming in 2017!
- Exclusion Screening and Background Checks in Dental Practices
- Medicare Dental: Significant Overpayments Have Been Made to Hospitals
- Dentists Participating in the Medicaid Program Must Exercise Caution to Avoid False Claims Act Liability
- Medicaid Dental Audit: Exclusion Screening Issues
- Dental Fraud Settlement — $5.05 Million to be Paid by Oklahoma Dental Practice in Medicaid Case.
- Medicaid Dental Fraud: Is the State of Texas Partly to Blame?
- Medicaid Dental Fraud: New Hampshire Dentist Indicted on Nearly 200 Counts of Medicaid Fraud.
- Medicaid Dental Fraud: Dentist Alleged to Have “Systematically Bilked” the State in Dental Fraud Scheme.
- Medicare Dental Services: Take Care to Ensure that Your Hospital Outpatient Dental Services Meet Medicare’s VERY Limited Coverage Requirements Before Billing the Program.
- Medicaid Dental Audits: Medicaid Dentists are Under the Microscope. Are Your Dental Records Complete and Accurate?
- TBDE Update: Texas State Board of Dental Examiners
- The False Claims Act: Is Your Dental Practice at Risk?
- ZPIC Audits of Specialty Dental Practices are Here! Is Your Dental Practice Ready?
- A “Credible Allegation of Fraud” Related to Medicare or Medicaid Services Will Result in Your Dental Practice Being Placed on “Suspension” or “Payment Hold.”
- Dental Practices Should Exercise Care Before Adopting Cloud Computing.
- Dental Audits: the New Enigma?
- Returning a Medicaid Dental Overpayment: Part II
- Returning a Medicaid Dental Overpayment: Part I
- Texas Medicaid Dental Claims Under Scrutiny
- As Medicaid RAC Audits Increase, so Does the Importance of Dental Compliance
- Components of an Effective Dental Compliance Plan
- Category: False Claims Act
- False Claims Act Penalties Have Almost Doubled Over the Last Year
- False Claims Act: Whistleblower Cases Have Continued to Rise Since the Passage of the Affordable Care Act
- A Recent False Claims Act Case Being Brought Against an Individual Physician has Resulted in a Record Recovery for the Government.
- Category: Firm News
- Upcoming Webinar — CJR/Bundled Payment Impact on Post-Acute Providers–Navigating Alternative Payment Systems (Intermediate)
- It’s Time for CMS and Congress to Review Outdated Medicare and Medicaid Provisions
- Certified Medical Compliance Officer Course
- Liles Parker’s Michael Cook Appointed to Virginia Board of Medical Assistance Services
- Heidi Kocher Joins Liles Parker PLLC as Counsel
- David P. Parker, Managing Partner at Liles Parker PLLC, has been selected for inclusion in Super Lawyers – Edition 2013 for the District of Columbia
- Liles Parker Attorney has Article Titled “Individual Liability in Medicare Overpayment Cases” Published in Law Journal.
- Liles Parker Attorney Serves as Speaker on Medicare Compliance Issues at the “2013 Health Care Summit” for West Virginia Physicians.
- Journal of Diabetes Science and Technology Includes Diabetic Testing Supplies Article by Liles Parker Attorney
- HHS-OIG Issues New Guidance on the Effect of Exclusion from Participation in Federal Health Benefits Programs.
- Liles Parker Attorney to Speak at National Conference for Medical Office Professionals
- Liles Parker Says “Thank You” to America’s Veterans — God Bless America
- Liles Parker Webinars Approved for Free AAPC CEUs
- ZPIC Audit Appeals Attorneys: Who is Right for You?
- Karen McKeithen Schaede Joins Firm
- Thanking Our Troops on This Memorial Day
- Liles Parker Partners Interviewed About SNF ZPIC Audits
- Liles Parker have moved locations. We are now in the Georgetown area of Washington, DC.
- Michael Cook and Lester Johnson Named Health Law Practice Group Leaders
- Robert Saltaformaggio and Jacob Harper Achieve Medical Reimbursement Certification
- Liles Parker Staff Member Achieves Certification as a Medical Compliance Officer
- Robert W. Liles will be Teaching PMI’s Certified Compliance Officer Program in Dallas, Texas.
- Michael Cook To Speak at the AHLA Conference on Long Term Care and the Law
- Liles Parker Expands its Houston Office in 2011.
- Michael Cook to Speak at National Conference On Health Care Reform
- American Health Lawyers’ Scholarly Journal Publishes Article by Michael Cook on Health Care Reform
- Leonard Schneider Wins Pivotal Lawsuit on Behalf of the City of Huntsville Against the Huntsville-Walker Chamber of Commerce.
- Robert W. Liles Invited to Speak at the DOJ / HHS-OIG Health Care Fraud Working Group Conference
- Rebecca Reed Has Been Appointed to the Bench as an Associate Judge
- Liles Parker Supports Arlington Pediatric Center
- Michael Cook Joins Firm as Of Counsel
- Robert W. Liles Participates in Meeting with Congressman Culberson and Health Care Association Representatives in Houston
- Leonard Schneider Joins Firm as Partner
- Category: Featured
- Indiana Prescribing Guidelines–Eff. July 1, 2017.
- UPIC Audits of Medicare Claims are Underway! Is Your Practice Ready?
- Chiropractic Audits by Medicare are Increasing!
- Payors are Aggressively Auditing Acupuncture Claims.
- Home Health Final Rule Creates New Exclusion Screening Obligation
- Are you Ready for the Next Round of CMS Re-Validation?
- Home Health Audits: Pre-Claim Demonstration Project Update – Part 1.
- Responding to Audits of Home Health Agencies by the Office of Inspector General of Home Health Agency Services
- Home Health Pre-Claim Review Demonstration Project Update!
- Home Health Pre-Claim Reviews Are Here!
- Medicare Revocation Actions / Medicare Deactivation Actions: How Should You Respond?
- CMS Seeks to Overhaul Medicare Claim Appeal Process
- CMS Announces Home Health Pre-Claim Review Demonstration Project for Five States
- CMS Expands Overpayment Claim Settlement Process to Include Part A Providers With Pending ALJ Appeals
- Home Health Provider Takes Historic $239,800 Hit for HIPAA Violation
- Texas SNFs — Medicare Audits of Ultra High Therapy Claims are Here!
- Federal Court Boosts Hospitals on ALJ Appeals Issue
- Providers, Hospitals and the Comprehensive Joint Replacement Program (CJR) – What You Need To Know!
- CMS Issues Rules for Comprehensive Care for Joint Replacement (CJR) Model
- DME Audits are Back! Are Your Claims Compliant?
- Ophthalmology Audits: Is Your Practice Ready for a Medicare Audit?
- ZPIC Audits and Their Use of the Fraud Prevention System
- How has your Home Health Agency Implemented the New Face-to-Face Rules?
- ZPIC Audit — CMS Issues New Instructions to its Contractors Regarding the Scope of Claim Appeals
- Structural Denial of Due Process in Peer Review Proceedings Under HCQIA
- CMS Awards ZPIC Contract for Zone 6 to SafeGuard Services
- Federal Anti-Kickback Statute: What Constitutes a Referral?
- HHS-OIG Releases 2015 Mid-Year Update to Work Plan
- The Medicare Appeals Process is Broken
- Home Health Enforcement: Are Additional Program Integrity Initiatives on the Horizon?
- Meaningful Use: Are You Prepared for an Audit by OCR or a CMS Contractor?
- Federal Efforts to Combat Health Care Fraud Pay Off With Over $27.8 Billion Recovered
- Category: Health Law Articles
- Pain Management Prescribing Practices and Audits.
- NBI MEDIC Referrals to Boards, OIG and DOJ are Here!
- UPIC / ZPIC / Health Integrity Opioid Audits and Audits of Other High Risk Drugs.
- Home Services (CPT® codes 99341-99350) Billed to Medicare are Actively Being Audited.
- HHS Issues Final Rule to Address Record High Medicare Appeals Backlog
- Medicare Fraud: Texas Health Care Fraud Enforcement Efforts Continue to Rise
- How Can Providers Challenge Medicaid Underpayment After Armstrong v. Exceptional Child Care Center ?
- Texas Physicians Must Establish “Defined Physician-Patient Relationship” for Online Prescription
- New Medicare Incentive Programs
- Dixon Conference 2015: Hospice
- Medicare Termination / Medicare Revocation Cases: Tips for Avoiding & Steps for Appealing.
- CMS Offers Labor Day “Sale” on Audit Appeals
- Peer Review Actions: How HCQIA Due Process Fails the Accused Physician
- HIPAA Risk Assessments are Essential to Avoid Liability: Part I: Risk Assessment
- OIG Study Finds Nursing Facilities Ineffective in Reporting All Allegations of Patient Abuse or Neglect
- Bundled Payments for Care Improvement Initiative (BPCI): CMS Adds Over 4,000 Additional Providers to its List of Eligible Organizations.
- CMS Extends Enrollment Moratoria For New Home Health Agencies And Ambulance Suppliers And Providers
- Home Health Agency Risks: Failure to Properly Screen and Conduct Background Checks on Applicants.
- Hospital Physician’s Role in Certifying Patient’s Eligibility for Home Health Benefit
- Physician Accommodations in CMS’s Face-to-Face Encounter Rules
- Importance of Screening Employees Against Medicare Exclusion Database
- Different Definitions of “ Medical Necessity ”
- Proposed Rule Seeks to Expand HHS-OIG’s Exclusion Authority
- Proposed Rule Seeks to Give HHS-OIG More Authority to Impose CMPs
- Hospice Providers – Don’t Forget About Your New Hospice Item Set Requirements!
- Responding to an Investigation by a TX Medical Board
- The Dangers of Keeping Medical Records in the “Cloud”
- Medicare Lifts Ban on Medicare Coverage for Sex Change Surgery
- Fed Up Over Burdensome RAC Appeals Process, Hospitals Sue HHS
- Preventing and Preparing for a ZPIC Audit
- Marketing Schemes: Physicians Warned About
- CMS Will Allow Certain Hospice Patients Both Palliative and Curative Care
- Criminal Attacks On Health Care Providers Rise 100% In Four Years
- ALJ Appeal: Special Considerations When Appealing Home Health Medicare Claims Before an ALJ.
- Home Health and Ground Ambulance Suppliers Beware!
- CMS and Contractors Must Address Vulnerabilities
- Strategic Health Solutions and Home Health
- RAC Audits: The AHA Argues that Fundamental RAC Reforms are Greatly Needed to Address Current Problems.
- HIPAA Breach: Dermatology Practice Settles Potential HIPAA Violations Following Data Breach.
- HHS-OIG’s Strategic Plan for 2014-2018
- RAC Audit Update: Hospitals are Seeing Dramatic Increases in RAC Audits
- Liles Parker Partner has Been Appointed to Serve on the Health Policy Council for New Virginia Governor.
- ICD-10 Basics for Small and Rural Practices
- HHS-OIG Reports: Safeguards Needed to Prevent Medicare Payments for Dead Beneficiaries and those Illegally in this Country.
- ZPIC Update: Health Integrity Educational Letters Sent to “Flagged” Home Health Agencies in Texas and Oklahoma.
- Wake Up Sleep Labs! HHS-OIG Has Focused the Light on Sleep Study Testing Services due to Repeated “Questionable Billing Practices”
- False Claims Act Lesson: “Hell Hath no Fury Like a Consultant Scorned.”
- ZPIC Alert: Chiropractor-Owned Multidisciplinary Practices Around the Country are Under Increasing Scrutiny and Audit by State Medical Boards and CMS Medicare Contractors.
- Complying with an Individual’s Request Under the “HIPAA Omnibus Rule” to Restrict the Submission of Protected Health Information.
- The HIPAA / HITECH Omnibus Final Rule is Here! Is Your Health Care Organization Complying with the Rules?
- The Texas Medical Board Disciplined 41 Physicians in August 2013.
- The Sunshine Act is Here — Are you Ready for Full Disclosure?
- Are Your Outpatient Therapy Claims Ready For Manual Review by a Medicare Recovery Audit Contractor?
- Are Medicare Opt-Out Concerns Overblown? HHS Study Finds that Physicians Choosing to Opt-Out of the Program are less than the Number of New Physicians Joining the Program.
- Prepayment Reviews and Postpayment Audits are Increasing in Frequency — New Guidance has Been Issued to ZPICs.
- Medicare Skilled Nursing Facility Update: Medicare Now Recognizes Same Sex Marriages and Allows for Care for Couples in the Same SNF.
- Rise of the UPICs – More Changes to the Medicare and Medicaid Audit Contractor Landscape are on the Horizon.
- Strategic Health Solutions is Currently Auditing E/M Claims Billed at the 99214 and 99215 levels. Are Your Documentation, Coding and Billing Practices Complaint?
- When is the Last Time You Reviewed Your Private Payor Contract in its Entirety? Now is the Time to Understand Your Obligations and the Obligations Owed to You by the Private Payor.
- Enforcement of Alleged “ Genetic Discrimination ” is Real – Just Ask the Nursing Home Recently Sued by EEOC! What Can you Do to Avoid Liability?
- “Under the Fifth Amendment, You Have the Right to Remain Silent.” Well. . . Maybe Not. Why Health Care Providers Should Care About the Case of Salinas v. Texas.
- Liles Parker Receives a Nice “Shout-Out” in the Wall Street Journal in Connection with its Health Care Work
- Strategic Health Solutions: The Latest CMS Contractor to Flex its Audit Muscles – Is Your Practice Ready to be Reviewed?
- Changes to the Recovery Audit Contractor (RAC) Program will be Major in 2014.
- Court Approves Settlement in Jimmo v. Sebelius –- Expands Coverage of Skilled Care For Home Health, SNFs, Outpatient Therapy and Inpatient Rehabilitation Facilities
- The Texas Medical Board Remains Busy Due to Abnormally High Number of Complaints Filed Against Physicians in 2012.
- The Texas Medical Board is Serious When it Comes to “Pain Clinics.” Are You Properly Supervising Your Prescribing Clinical Staff?
- ZPIC Audits of DME Suppliers Billing for Back Braces are Likely to Further Intensify
- Medicare Overpayments: Congress Extends the Period Within Which the Medicare Program Can Recover Overpayments
- HIPAA Breach Penalties are Being Assessed for Potential Disclosures of Less than 500 Patients. Have You Taken Steps to Prevent a Breach?
- Medicare Recovery Audit Contractors (RACs)
- Continuing ZPIC Audits of Home Health Agencies
- OIG Identifies Substantial SNF Medicare Overpayments
- The “Medicare Audit Improvement Act” Appears Promising at First Glance. Is it Really the Answer?
- Settlement in Jimmo Case Would Expand Medicare Coverage of Skilled Care
- Individual Liability for Medicare Overpayment Claims
- Payments to ZPICs from CMS Have Been Significant
- HHS-OIG Finds ZPICs Have Conflicts of Interest
- ZPIC Prepayment Review
- Medicare Audits in Miami, FL
- CMS To Begin RAC Prepayment Reviews on August 27
- Medicare Appeals – An Overview of the Process for New Providers
- FCA Statute of Limitations Issue
- SNF Prepayment Review by ZPICs
- Medicare Audits in Baton Rouge, LA
- Medicare Audits in Houston, TX
- Medicare Administrative Contractor (MAC) Update
- Supreme Court Rules Affordable Care Act (ACA) Constitutional
- QIC v. AdQIC: A Refresher
- Duties of Referring and Ordering Physicians
- NFLPA Collusion Suit Against NFL Alleges Conspiracy
- Medicaid RACs to Increase Enforcement Efforts
- Medicaid MIC Audits to Increase
- Jurisdiction H: Novitas Posts New FAQs and EFT Alerts
- CMS Initiative on Reducing Hospital Admissions
- Connolly Posts New Issue for Hospice Billing
- Highmark (MAC Jurisdiction H) Dates Released
- Medicaid RAC Program Up and Running – 26 States Award RAC Contracts
- OMHA Changes ALJ Hearing Case System
- AdvanceMed Brings Prepayment Review to Georgia
- CMS Issues Proposed Rules About Returning Medicare Overpayments
- Prepayment Audits and Reviews by RACs are Back and Here to Stay! Are You Ready for a Prepayment Audit by a ZPIC or RAC?
- Medicare Audits – RACs, ZPICs, MICs, OIG and Now. . . Patients?
- rt CMS Delays RAC Prepayment Review Demonstration Project . . . For Now.
- RAC Prepayment Reviews of Medicare Claims Are on the Horizon
- Medicare Post Payment Audits and the “Average” Provider
- Fundamental Medicare Compliance Concepts Everyone Can Understand, Use and Follow!
- ZPICs, PSCs, and RACs are Conducting Audits of SNFs — Skilled Therapy and Skilled Nursing Services Must be Fully Documented and Must Comply with Medicare’s Coverage Requirements
- A Virginia Physician Who Wrongfully Disclosed Patient Health Information is Being Prosecuted by the Feds
- Texas Physicians are Starting to Level the Playing Field in Their Dealings with the Texas Medical Board.
- Lose Your Appeal at Reconsideration? Consider an ALJ Hearing
- Physician Employment Agreements: What They Didn’t Teach You in Medical School.
- CMS Proposes Regulations Regarding Medicaid Payment Rates – Potential Game Changer for Hospitals, Nursing Homes and Other Medicaid Providers
- New Face-to-Face Requirement for Hospices and Home Health Agencies
- Predictive Modeling: ZPICs Using Data Mining to Identify Fraud
- AdvanceMed, the ZPIC Responsible for Zone 2 and Zone 5 has Reportedly Been Acquired by NCI
- When it Rains, it Pours . . . DME Suppliers are Facing Even More Regulations — An Effective Compliance Program is Important Now, More than Ever Before.
- Report by HHS-OIG Precedes Increase in ZPIC Audits of SNFs
- The ZPIC Audit and Appeals Process
- Post-Payment Audits Conducted by Medicare Contractors: An Overview of the CERT Audit Process
- Texas Providers Should Expect Sharp Increase in Post-Payment Audits of E/M Claims Billed to Medicare.
- Are Medicare ALJ’s Truly Independent Fact Finders, Free From the Informal Pressures of CMS and its ZPIC / PSC / RAC / QIC Contractors?
- ZPICs and PSCs Will Now Be on the Lookout for “Date Stamps” Used by Home Health and Hospice Providers.
- Be Prepared — ZPIC, PSC and QIC Representatives Are Increasing their Participation in Appeal Hearings, Personally Presenting Their Rationale for Denying Your Medicare Claims to the ALJ.
- 2011. . . The Year of Compliance — Medicare Suspension Actions and the Impact of the Affordable Care Act on Future Suspension Actions.
- White House Issues Executive Order to Improve the Regulatory Process, Make it More User Friendly and to Avoid Adverse Consequences to Job Creation and Economic Growth
- 2011. . . The Year of Compliance — Avoiding ZPIC Audits and Suspension Actions
- Top Ten Health Care Compliance Risks for 2011.
- Keeping an Eye on Medicare’s AdQIC
- Virginia Judge Concludes That Health Care Reform Law is Unconstitutional
- Employee Screening Practices Scrutinized by HHS-OIG
- Health Care Reform- The Independent Payment Advisory Board (IPAB) And Its Implications on Health Care Providers
- The AHA Expresses its Concerns with Recent False Claims Act Actions
- HHS-ONC Names EHR “Authorized Testing and Certification Bodies”
- Data Mining Used by DOJ to Target Health Care Providers
- President Obama enacts the “Improper Payments Elimination and Recovery Act”
- States Are Taking Aim at Home Health Providers
- South Texas Medicare Providers are Under the ZPIC Microscope
- HHS / CMS Issues Final “Meaningful Use” Objectives for Electronic Health Records (EHRs). Providers Should Exercise Extreme Caution Before Converting to an EHR System.
- ACA Creates a Minefield for Medicare Providers Who Fail to Promptly Return Overpayments
- President Obama Appoints New Head of CMS
- Enactment of “Doc Fix” Bill Offers Another Temporary Reprieve for Medicare Physicians
- Counsel for HHS-OIG Discusses the Impact of Health Care Reform on Enforcement with Congress
- President Obama Publicizes Measures to Fight Health Care Fraud
- Are ZPICs Tougher than RACs When Conducting Medicare Audits?
- Category: ACA
- Category: Compliance
- Screening and Evaluating Employee Suitability: The New “Seventh Element” of Compliance.
- OIG And DOJ Issue Important New Compliance Guidance
- Basic Policies and Procedures for a Compliance Program
- Exclusion Screening Enforcement Actions by OIG are Increasing.
- Looking a Gift Horse in the Mouth (or how to deal with holiday gifts)
- CMS’ “Probe and Educate” Program is Underway for Home Health Agencies – Are You Prepared?
- Compliance Officers and Compliance Committees
- How to Implement a Compliance Plan in Your Practice
- Despite CMS’ February Prediction, Medicare Advantage Payments Set to Rise in 2016
- Administration’s FY 2016 Budget Proposal Includes Changes to Recovery Audit Procedures
- Massive Breach at Health Insurer Anthem
- CMS Implements Improvement in the RAC Program
- Cloud Storage Providers & BAAs – Where is Your Data?
- OIG Proposes New Anti-Kickback Law Safe Harbors
- HIPAA Risk Assessments are Essential to Avoid Liability: Part II: Risk Analysis
- Oncology Fraud: Michigan Oncologist Indicted for Prescribing Medically Unnecessary Chemotherapy and Other Treatment Regimens
- CMS Clarifies HHA Definition of “Confined to Home”
- It’s “Official” – ICD-10 Implementation Begins October 1, 2015
- Compliance Plans: Are They Mandatory or Not?
- CMS’ Proposed Rule Would Update 2015 Home Health Prospective Payment System, Includes Important Updates and Additional Proposals
- CMS Proposes Changes to Medicare Home Health Benefit Face-to-Face Encounter Requirement
- CMS Guidance on the Role of the Medical Director
- Federal Government Made $100 Billion in Improper Payments in 2013
- OSHA Standards for Physician Offices
- Investigations of Medicaid Dental Fraud in Texas
- Protecting Health Information: Texas HB 300
- Improper Payments for Miscoded E/M Services Cost Medicare $6.7 Billion
- Consequences of HIPAA Noncompliance
- Medicare Face-to-Face Rules: Home Health Trade Association Fights Back.
- OCR to Covered Entities, Business Associates: Encryption Is Your Best Defense against HIPAA Violations
- Covered Entities and Business Associates Beware! HHS OCR Announces Latest Survey in Preparation for New HIPAA Audits
- CMS Announces RAC Audit “Pause” and Additional RAC Program Reforms
- Texas Medicaid Providers – Have You Implemented Your Effective Compliance Plan Yet?
- Novitas Reminds us of the Impending ICD-10 Transition Date: October 1, 2014
- Face to Face Encounter: Performing it properly?
- HIPAA Risks of Breach: Windows XP Will No Longer be Supported by Microsoft
- OIG Releases its 2014 Work Plan.
- Has Your Practice Implemented the Final Omnibus Rule Requirements?
- “Effective Compliance” Encompasses Far More than Merely Coding and Billing Obligations. Discrimination Can Result in Serious Enforcement by the Office of Civil Rights (OCR).
- ICD-10 Will be Here Soon. Is Your Practice Ready?
- CMS Issues Instructions on the Impact of Sequestration on Survey and Certification Activities – How Will it Affect Providers?
- Does One of Your Employees Suffer from a Chronic Illness or Medical Condition? Consider the ADA When Assessing Their Request for Additional Medical Leave
- Liles Parker Attorney Achieves Recognition as a Certified Medical Compliance Officer
- Medicaid and CHIP Audits are Increasing Under CMS’ PERM Audit Program
- Predictive Modeling is Proving to be an Invaluable Targeting Tool for ZPIC Audits and RAC Audits.
- Texas Medical Board Complaints are Serious Business — Don’t Take their Concerns Lightly.
- Prepayment Reviews of Home Health Agency Claims are Increasing. Is Your Documentation Compliant?
- Medicare Exclusion Screening is Essential to Your Compliance — Failure to Properly Screen Can be Quite Costly for Health Care Providers.
- Medicare’s EHR Incentive Program: Will Identified Problems Lead to Greater Scrutiny?
- Home Health Agencies, Physicians and other Providers are Being Placed on Prepayment Review in Unprecedented Numbers. Are You Ready for an Audit?
- Healthcare Billing & Management Journal Includes Cloud Computing Article by Liles Parker Attorney in its Latest Edition
- OIG Scrutinizes Medicaid Personal Care Services
- Update: 1135 Waivers
- Health Systems Brace for Hurricane Sandy
- FCA Express Certification Liability Theory
- Texas Medical Privacy Act Takes Effect
- What Should I Do If I Discover A Breach of PHI?
- Is Your Home Health Agency Employing a Physician to Conduct Face-to-Face Visits? Have You Assessed the Risks?
- Hospice Fraud in the News
- Employing Excluded Individuals Can Cost You
- Outsourced Billing and Coding – Compliance Risks
- Healthcare Cloud Computing – Compliance Risks
- Major HIPAA Breach: Be Aware of Subcontractors
- Texas HHAs Remain Under Scrutiny
- Elements of a Compliance Plan
- Data Mining in Medicare Fraud: Usage and Effects on Healthcare Providers
- Social Media and Healthcare: A Little More Complicated
- HHS-OIG Has Found that E/M Coding is Trending Higher
- Social Media and Healthcare: Concerns for Providers
- National Site Visit Contractor Established
- Medicaid Therapy Services in Texas
- 100 Involved in Health Care Fraud Arrests
- Health Care Reform: Day 1 at the Supreme Court
- Nevada Providers: Prepare for Medicaid RAC Audits
- TX and OK Home Health Agencies: Beware of Home Health Compliance Risks
- HIPAA Compliance Is Becoming More Important Every Day
- TrailBlazer Loses MAC Bid Protest
- The Physician Payment Sunshine Rules
- Data Mining Assessment Tools Can Serve as an “Early Warning System” of Possible Problems
- CMS is Now Actively Auditing Providers Who Took EHR Incentive Program Funds
- Are HIPAA Whistleblower Provisions Around the Corner? How Does This Affect Your Compliance Efforts?
- HIPAA Audits are Here. Are Your Privacy Practices Fully Compliant?
- CERT Audits are Serious – Don’t Take them Lightly
- CMS’ New “Physician Compare” Website to Report on Provider Performance
- Conducting a Gap Analysis or Mock Audit: Two Essential Compliance Tools Every Compliance Officer Should Be Familiar With
- ZPIC Audits: Health Integrity’s Audit of Texas and Oklahoma Home Health Agencies are on the Rise — Do You an Effective Compliance Plan in Place?
- The Number of ZPIC Audits Being Conducted are Increasing — Have You Taken Steps to Help Ensure that Your Claims Meet Medicare’s Coverage and Payment Requirements? Ten Steps You Can Take to Improve Your Organization’s Compliance with Medicare’s Rules and Regulations.
- ZPIC Audits of DME Providers Continue to Climb and HHS-OIG Finds that More than Half of All Power Wheelchairs Claims Paid by Medicare are Improper
- Red Flag Rules Update – Health Care Providers Are Not Covered Under the Rule
- “Form I-9” Practices for Health Care Providers
- Under Health Care Reform Legislation, Stark’s Whole Hospital and Rural Provider Exceptions are Changing
- Existing Home Health Agencies are Considered a “Moderate” Risk According to CMS for Screening Purposes Under its Recent Proposed Rule
- CMS Publishes Stark Self-Disclosure Protocol
- CMS Issues “Medical Records Retention” Reminder
- ZPICs and PSCs are Enforcing Strict Medicare Signature Requirements
- Identity Theft “Red Flags” Rule Treating Doctors Like Banks Is Delayed Once Again
- GAO Testimony Recommends CMS Improve Enrollment, Payment, and Oversight Procedures to Prevent Medicare Fraud, Abuse, and Waste
- Responding to a Search Warrant of Your Practice or Clinic
- Medicaid Audits: HHS-OIG Reports that Four Types of Errors Accounted For 95% of the Net Improper Medicaid Overpayments
- Your Next “Patient” May be an Undercover Agent Peforming a Medicare Audit on Your Practice.
- Category: HEAT Strike Force
- South Texas Health Care Providers Remain Under Considerable Scrutiny by HEAT Prosecutors and Investigators
- Health Care Fraud Enforcement Takes an International Turn
- South Texas Home Health Nurse Convicted of Health Care Fraud
- Additional Cities will have HEAT Teams in 2011
- Medicare Fraud Strike Force Operation Leads to Charges against 94 Defendants, including 4 in South Texas
- HEAT Strike Force Update: Prosecutions in Texas Increased in March 2010
- Category: Medicaid
- Category: Medicare Overpayments
- “Piercing the Corporate Veil”: How Owners Can Be Liable For Business Debt
- ZPIC Audit Targeting Tools: Health Care Providers with “High Cumulative Payments” are Under the Audit Microscope. Have You Implemented an Effective Compliance Plan?
- Medicare Cloning: “Gaming the System” – How EHRs Which Encourage Cloningand Other Improper Practices Can Lead to Overpayments and Worse.
- Seven Elements of a “Payable Claim” are an Essential Tool When Preparing for a ZPIC Audit
- CMS Authorizes Medicare Contractors to Accept Administrative Appeals by Facsimile and Secured Internet Transmission
- Health Data Insights Begins Medical Necessity Reviews
- Region B RAC CGI Announces that it will Begin Review of Eighteen Projects that Involve Medical Necessity
- With ZPICs, PSCs, and RACs Fighting Most Challenges to Their Extrapolation, Experience Counts
- Providers Should Exercise Caution When Handling Overpayments — More Than Likely, You Can’t Keep It, Even if the Payor Doesn’t Want it Back!
- Don’t Take ZPIC or RAC Extrapolation Calculations at Face Value – Can Their Results Be Readily Reproduced?
- Can ZPICs Use Minimal Reviews to Maximize Recoupment? Maybe. . . Maybe Not. . .
- A Look at RACs — Part III: What Should Physicians and other Medicare Providers Know about Appeals and Recoupment?
- A Look at RACs — Part II: How Should Physicians and Other Providers Respond to a RAC Audit?
- A Look at RAC Audits — Part I: What Do Physicians, Home Health, Hospice, and DME Providers Need to Know?
- For AdvanceMed, it’s Not Personal, Just Business – Big Business
- More “Bounty Hunters” Conducting Medicare Audits?
- Overview of Zone Program Integrity Contractors ( ZPIC )
- ZPIC Audits in Texas are Increasing – A New Sheriff in Town?
- Category: Regulatory Issues | Privacy
- Maryland Limits on Opioid Prescriptions.
- Opioid Prescribing Practices & NBI MEDIC / UPIC / ZPIC and Board Actions.
- Cell Tower Ground Lease Renewals and Purchases
- What is Civil Fraud?
- Guide to Efficient Business Transactions: Part III
- Guide to Efficient Business Transactions: Part II
- Guide to Efficient Business Transactions: Part I
- Contract Basics – What is a Contract?
- Non-Disclosure Agreement – Checklist for the Recipient
- Liquidated Damages – Don’t Take a Bath When You Cancel a Contract
- “What do you really owe when a debt collector calls?”
- “Beware of Small Print – It Can be Bad for Your Wallet”
- “There is a fiduciary duty here. It’s really inconceivable to us.”
- “A verbal contract isn’t worth the paper it is written on.”
- Part III: Analysis and Conclusion
- Part II: The “Zone of Insolvency” — the Delaware Example
- Part I: The Fiduciary Duties of Officers and Directors of Insolvent Corporations
- D&O Insurance Coverage: Understanding the Role of Outside Directors
- The Dodd-Frank Act and Major Corporate Governance Reform
- Category: Uncategorized
- Dixon Conference 2015: Home Health
- Liles Parker Attorney Asked to Speak at the Texas Dental Association’s Annual Meeting in San Antonio, Texas
- Peddling and Soliciting, Municipal Regulations These Issues Can be Complex. Is Your City Clear on these Points?
- Maryland Anti-Bullying, Cyber Bullying and Hazing Laws
- Virginia Anti-Bullying, Cyber Bullying and Hazing Laws
- Significant Concepts under Section 504 and the ADA
- Section 504 and the Americans with Disabilities Act
- OSEP Monitoring
- What If Parents Don’t Agree With the IEP?
- Reviewing and Revising the IEP
- Implementing the IEP
- After the IEP is Written
- Deciding Placement
- Writing the IEP
- IEPs and Transition Services
- Related Services
- The Regular Education Teacher as Part of the IEP Team
- The IEP Team Members
- A Closer Look at the IEP
- The Basic Special Education Process Under IDEA
- Overview of an Individualized Education Program
- Can an Attorney for the School Attend an IEP Team Meeting?
- City Contracts and Arbitration
- Hotel Occupancy Tax Funds – Management and Duty – Part III of III
- Hotel Occupancy Tax Funds and Proper Use – Part II of III
- Hotel Occupancy Tax Funds: What are They? Part I of III.
- What Can Cities Do About Dangerous Buildings?
- Contracts and Cities 101
- Mechanic Liens against Public Property
- Limitations and City Claims
- Cities and Trade Secrets
