Sitemap
Pages
- AMBA Webinars
- Areas of Practice
- Ashley Morgan
- Attorney Co-Counsel/Referrals
- Charles E. Abney, J.D., M.D.
- Client Testimonials
- DEA Audits / DEA Registration Defense / DEA Enforcement Actions
- Ismail (Ish) Laher
- Jennifer Papapanagiotou
- Liles Parker ‘Provider Hour’ Webinar Series
- Lorraine Ater Rosado
- Mary Soule
- Matthew Kelly
- Meaghan McCormick
- Meet our Attorneys
- Michael Cook
- Natalya “Natasha” Bull
- Non-Legal Resources – Test
- Robert W. Liles, J.D., M.B.A., M.S.
- Senior Staff
- TAHCH Webinars
- We always offer a FREE INITIAL DISCUSSION
- Webinars Playback
- About Us
- Areas of Practice
- Compliance Program Development and Implementation
- Debt & Equity Finance
- Dental Law
- False Claims Act Matters and Cases — An Overview
- Health Care
- Anti-Kickback Statute
- Accreditation and Certification
- Administrative Law Judge
- Ambulance Companies
- Conditions of Participation
- Corporate Integrity Agreements
- DME Companies
- Federal District Court
- Fee-splitting
- Home Health Agencies
- Hospices
- Hospitals
- Initial Records Request
- Licensure
- Medicare Appeals Council
- Medicare Audits by ZPICs, MACs, RACs and CERTs
- NPDB Reporting Issues
- OSHA Requirements and Training
- Physical, Speech and Occupational Therapy
- Physicians and Practice Groups
- Rebuttal
- Reconsideration
- Redetermination
- Reimbursement
- Skilled Nursing Facilities
- Stark and Physician Self-Referral Laws
- State Medical Board Representation
- Subpoenas, Search Warrants, Investigations
- HIPAA Audits and Compliance
- Mergers & Acquisitions
- Registered Nurse (RN) / Advanced Practice Registered Nurse (APRN): State Nursing Board Complaints.
- Regulatory Changes / Privacy / Corporate Transactions
- State Dental Board Complaints Against Dentists, Dental Hygienists, Registered Dental Assistants, Dental Laboratories and Mobile Dentistry Facilities
- UPIC Audits are Here! Are You Prepared for an Audit by Medicare’s Newest Program Integrity Contractor?
- White Collar Defense
- Zone Program Integrity Contractor (ZPIC) Investigations and ZPIC Audits
- Senior Staff
- Contact Us for a Free Appt.
- Our Locations
- Calendar
- Disclaimer & Privacy Policy
- Other Firm Blogs
- Webinars
- Non-Legal Resources
- Andrew C. Lynch
- Heidi Kocher
- Jason Cabell
- Leonard Schneider
- Lester W. Johnson, Jr.
- Richard Pecore
Posts by category
- Category: Dental Audits & Compliance
- The Dangers of Billing Payors for the Services of a Non-Credentialed Dentist / Non-Participating Dentist
- Aetna’s SIU is Actively Auditing Dental Claims. Are Your Dental Services Compliant with Applicable Regulatory and Contractual Requirements?
- Mobile Dentistry in Texas – An Overview of Regulatory Risk Areas to be Considered
- UPIC Dental Audits (Such as Qlarant Dental Audits) Have Been Initiated. Is Your Practice Ready for its Medicare Dental Claims or Medicaid Dental Claims to be Audited?
- Dental Claims Audits are on the Rise
- Dental Fraud: Dentist Faces 3,974 Years in Prison if Convicted!
- Medicaid Dental Audits of IV Sedation Services
- Delta Dental Audits are Ongoing Around the Country. Are You Prepared?
- Medicaid Dentist Eligibility Audits are Ongoing Around the Country
- Dental Practice Audits are on the Rise — Protect your Interests!
- More Texas Medicaid Dental Audits Are Coming in 2017!
- Exclusion Screening / OIG Screening and Background Checks in Dental Practices
- OIG Finds Significant Medicare Dental Overpayments Made to Hospitals
- Dental Claims False Claims Act Liability
- Medicaid Dental Audits: Exclusion Screening Issues
- Dental Fraud Investigation Results in $5.05 Million Recovery
- Texas Medicaid Dental Fraud: Is the State Partly to Blame?
- Investigations of Medicaid Dental Fraud in Texas
- Dentist Indicted on Nearly 200 Counts of New Hampshire Medicaid Dental Fraud
- Dentist Alleged to Have “Systematically Bilked” MassHealth Dental Fraud Scheme
- Hospital Outpatient Dental Services are Being Audited
- Is Your Dental Practice Prepared to Undergo a Medicaid Dental Audit?
- TSBDE Update: Texas State Board of Dental Examiners
- Improper Medicaid Dental Billing Practices Can Result in False Claims Act Liability
- Medicare Dental Audits are Being Conducted by ZPICs. Is Your Specialty 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 Cloud Computing Options Must be Carefully Analyzed Before Moving Your Data to the “Cloud.”
- Overseas Outsourced Billing and Coding – Compliance Risks
- There are Seven Compliance Plan Elements – Is Your Healthcare Company Compliant?
- MIC Dental Audits: Are Your Dental Practices Compliant?
- Returning a Medicaid Dental Overpayment: Part II
- What are a Dentist’s Medicaid Overpayment Obligations? Part I
- Texas Medicaid Dental Claims Are Under Audit Scrutiny
- As Medicaid RAC Dental Audits Increases, so is the Importance of Dental Compliance.
- Components of an Effective Dental Compliance Plan
- Category: Firm News
- Michael Cook, Keynote Speaker at the CMS 2019 Medicare Advantage Home Care National Summit
- Liles Parker Partner, Michael Cook, Named as an American Health Lawyers Association Fellow (AHLA)
- Michael Cook Speaking at the American Health Lawyers Association Institute
- Michael Cook on “The Future of the Medicaid Program in Long Term Care”
- Michael Cook Moderating a panel of State Medicaid Directors and Deputies
- Liles Parker’s Attorney Ashley Morgan named a ” Super Lawyer — Rising Star “
- My Weekend Volunteering at the Wise County Free Clinic
- Liles Parker Partner, Michael Cook, Receives Albert Nelson Marquis Lifetime Achievement Award
- Michael Cook appointed to serve on Virginia’s Medicaid Policy Council
- Maryland-National Capital Homecare Association Annual Meeting
- Michael Cook awarded the Marquis Lifetime Achievement Award
- Upcoming Webinar — CJR / Bundled Payment Impact on Post-Acute Providers
- 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
- Dixon Conference 2015: Home Health
- Heidi Kocher Joins Liles Parker PLLC as Counsel
- David P. Parker Has Been Selected as a Super Lawyer
- Liles Parker Article on Medicare Overpayment Individual Liability Published in American University Law Journal
- Liles Parker Attorney Presented at the West Virginia Physician Summit
- Liles Parker Receives a Nice “Shout-Out” in the Wall Street Journal in Connection with its Health Care Work
- Journal of Diabetes Science and Technology Includes Diabetic Testing Supplies Article by Liles Parker Attorney
- Liles Parker Attorney Asked to Speak at Annual Meeting of the Texas Dental Association
- Liles Parker Attorney to Speak at National Conference for Medical Office Professionals.
- Liles Parker Attorney Achieves Recognition as a Certified Medical Compliance Officer – CMCO
- HBMA Journal Includes Cloud Computing Article by Liles Parker Attorney in its Latest Edition
- Liles Parker Says “Thank You” to America’s Veterans — God Bless America
- Liles Parker Webinars 2012 — Approved for Free AAPC CEUs
- Karen McKeithen Schaede Joins Firm
- Thanking Our Troops on This Memorial Day
- Liles Parker Partners Interviewed About SNF ZPIC Audits
- Liles Parker has moved its DC Office.
- Michael Cook and Lester Johnson Named Health Law Practice Group Leaders
- Robert Saltaformaggio and Jacob Harper Achieve CMRS Certification
- Liles Parker Welcomes Paul Weidenfeld to the Firm
- Paralegal Edward Dickey Achieves Certified Medical Compliance Officer Status
- PMI’s Certified Medical Compliance Officer Program
- Michael Cook To Speak at Long Term Care Conference
- Liles Parker Expands its Houston Office in 2011
- Michael Cook to Speak on The Future of Healthcare.
- American Health Lawyers’ Scholarly Journal Publishes Michael Cook’s Health Care Reform
- City Attorney Leonard Schneider, J.D., Wins Pivotal Lawsuit on Behalf of the City of Huntsville, TX
- Robert W. Liles Invited to Speak at the WDTX DOJ Working Group for Health Care Fraud Meeting
- Rebecca Reed Has Been Appointed Assistant Judge in Bexar County
- 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: Home Health & Hospice
- Home Health Agency Alert: The Review Choice Demonstration Project start dates for Ohio, Texas, North Carolina and Florida are Around the Corner!
- Home Health Agency Alert: The Review Choice Demonstration Project is Moving Forward in Illinois Effective June 1, 2019
- CMS has Ended its Moratorium on New Home Health Agencies in Texas, Illinois, Michigan and Florida. Unfortunately, the Lifting of the Moratorium Isn’t Necessarily a Good Thing for Existing Home Health Agencies.
- Texas Prosecutors are Aggressively Targeting Criminal Home Health Fraud
- Home Health Providers Under the Microscope — The Review Choice Demonstration Project is Here
- Personal Care Services Are Under the Government’s Microscope
- Medicare Home Services (CPT® codes 99341-99350) are Being Audited
- Home Health Final Rule Creates New Exclusion Screening Obligation
- Home Health: Pre-Claim Review Demonstration Project
- Responding to OIG Home Health Audits
- Home Health Pre-Claim Review Demonstration Project Update!
- Home Health Pre-Claim Reviews Are Here!
- CMS Announces Home Health Pre-Claim Review Demonstration Project for Five States
- Home Health HIPAA Violation Costs $239,800!
- Medicare’s Home Health Probe and Educate Program is Underway
- Medicare’s New Face-to-Face Rules Must be Implemented
- Are More Home Health Program Integrity Initiatives on the Horizon?
- CMS Has Clarified the HHA Definition of When a Patient is Confined to Home
- CMS’ Proposed Rule Updates 2015 Home Health PPS Rates
- Physician Certification of Home Health Eligibility
- Physician Accommodations in CMS’s Face-to-Face Encounter Rules
- CMS Proposes Changes to Medicare Home Health Benefit Face-to-Face Encounter Requirement
- Medicare’s Face-to-Face Examination Rules: Home Health Trade Association Fights Back
- Medicare ALJ Appeals of Denied Home Health Claims
- CMS Has Announced that it is Extending Home Health Enrollment Moratoria
- Home Health Face-to-Face Encounters: Is Your Agency Performing it Properly?
- Health Integrity Educational Letter Sent to Home Health Agencies in Texas and Oklahoma
- Home Health Prepayment Reviews are Increasing. Is Your Documentation Compliant?
- ZPIC Home Health Audits are Slated for the Future
- Is Your Agency Employing a Physician to Conduct Home Health Face-to-Face Visits? Have You Assessed the Risks?
- Is Your Texas Home Health Agency at Risk for an Audit by Health Integrity?
- Home Health Compliance Risks are a Significant Issue for Texas and Oklahoma Agencies
- Health Integrity Audits of Texas and Oklahoma Home Health Agencies are on the Rise.
- New Face-to-Face Requirements for Hospices and Home Health Agencies
- South Texas Home Health Fraud Case Results in Nurse Prosecution
- Existing Home Health Agencies Considered a Moderate Risk
- MFCU Strike Force Teams are Taking Aim at Home Health Providers
- RAC Audits of Physician Practices, Home Health, Hospice, and DME Providers, are Expected to Increase.
- Category: Medicare, Medicaid & Private Payor Updates
- Genetic Testing Fraud Prosecutions are on the Rise Around the Country. Are Your Genetic Testing Practices Compliant?
- OIG’s Renewed Interest in Orthotic Audits and Investigations: What Your DME Company Needs to Know
- Audits of Telehealth Services are Increasing. Do Your Telehealth Services Meet Applicable Requirements?
- EKRA: Laboratories, Treatment Homes and Clinical Treatment Centers Now Face Increased Enforcement and Penalties for Kickback Tainted Claims that are Reimbursed by Private Payors.
- Transcranial Magnetic Stimulation Claims Audits by Medicare MACs and UPICs are Underway. Are Your CPT 90868 Claims Compliant?
- Is Your Urogynecology, OB/GYN or Multidisciplinary Practice Prepared for a Medicare Biofeedback Claims Audit or a Pelvic Floor Therapy Claims Audit?
- CMS has Confirmed the Coverage of Personal Care Services by Medicare Advantage Plans Starting 2019
- An Overview of Administrative Rheumatology Audits / Adverse Actions AND Civil / Criminal Enforcement Actions
- Expect an Increase in Audits of Chiropractic Services!
- CBRs for Spinal Orthoses (CBR201803): What Do You Need to Know?
- ZPIC Audits / UPIC Audits: The Impact of Transmittal 768 on the Medicare Appeals Process Timeline
- Medicare Advantage Plans May Soon Offer Personal Care Services
- The PSAVE Pilot Program: Should You Self-Audit Your Medicare Claims?
- Veterans Administration and CMS Announce Partnership to Address Fraud Prevention
- Revocation of Your Medicare Billing Privileges
- UPIC / ZPIC Referrals to State Boards, Societies, Surveyors and QIOs
- Pain Management Prescribing Practices and Audits.
- Maryland Limits on Opioid Prescriptions
- Indiana Opioid Prescribing Guidelines–Eff. July 1, 2017.
- Opioid Prescribing Practices & NBI MEDIC / UPIC / ZPIC and Board Actions
- NBI MEDIC Referrals to Boards, OIG and DOJ are Here!
- UPIC / ZPIC / Health Integrity Opioid Audits and Audits of Other High Risk Drugs.
- False Claims Act Penalties Have Almost Doubled!
- UPIC Claims Audits of Medicare Services are Underway! Are You Ready?
- Medicare Chiropractic Audits are Increasing!
- Private Insurance Payors are Aggressively Conducting Acupuncture Audits
- Are you Ready for the Next Round of CMS Revalidation?
- HHS Issues Final Rule to Address Record High Medicare Appeals Backlog
- Responding to a Medicare Revocation Action / Medicare Deactivation Action
- CMS Seeks to Overhaul Medicare Claims Appeal Process
- CMS Expands ALJ Appeal Claim Settlement Process to Include Part A Providers
- Texas SNFs — Medicare Audits of Ultra High Therapy Claims are Here!
- Update on American Hospital Association v. Burwell
- Coverage and Payment of New Products – CPT / HCPCS Code Issues
- Providers, Hospitals, and the CJR Program – What You Need To Know!
- CMS Issues Rules for Comprehensive Care for Joint Replacement (CJR) Model
- Basic Compliance Policies and Procedures
- DME Audits are Back! Are Your Claims Compliant?
- Exclusion Screening Enforcement Actions by OIG are Increasing.
- Does Your Practice Have a Compliance Officer or Compliance Committee?
- Medicare Fraud Enforcement Efforts Are Rising in Texas
- Medicare Ophthalmology Audits: Is Your Practice Ready?
- ZPIC Use of the Medicare Fraud Prevention System
- CMS Issues New Instructions to its Contractors Regarding the Scope of Claim Appeals
- Structural Denial of Due Process in HCQIA Peer Review Proceedings
- How to Implement a Compliance Plan in Your Practice
- CMS Awards Zone 6 ZPIC Contract to SafeGuard Services
- Challenging Medicaid Underpayments: Impact of the Armstrong Case
- Supreme Court Applies Health Insurance Tax Credits Nationwide
- What is a Referral Under the Federal Anti-Kickback Laws?
- The 2015 Mid-Year OIG Work Plan Has Been Released
- The Medicare Appeals Process is Broken
- Medicare Advantage Payments Set to Rise in 2016
- Responding to a EHR Meaningful Use Audit
- 2014 HCFAC Report — $27.8 Billion Recovered for Medicare
- The FY 2016 Budget Proposes Medicare Appeals Process Reforms
- Individual Liability for Medicare Overpayment Claims
- Texas Physicians — Is There a Defined Physician-Patient Relationship?
- Massive Anthem Data Breach
- New Medicare Incentive Programs
- CMS Implements RAC Program Improvements
- Cloud Storage Providers & BAAs – Where is Your Data?
- Dixon Conference 2015: Hospice
- HIPAA Security Risk Assessments are Essential
- Medicare Revocation Action: Steps for Avoiding and Appealing
- CMS Offers Labor Day “Sale” on Audit Appeals
- Oncology Fraud: Michigan Oncologist Indicted
- Peer Review: How HCQIA Due Process is a Fiction
- A HIPAA Risk Assessment is Essential to Avoid Liability
- OIG Finds Nursing Homes Not Reporting Patient Abuse and Neglect
- It’s Official: ICD-10 Implementation Begins October 1, 2015
- CMS Adds Over 4,000 Organizations to BPCI Initiative
- CMS Extends HHA Enrollment Moratoria
- Mandatory Compliance Programs for Medicaid & Medicaid Providers?
- OIG Report on the Nationwide Background Check Program
- Importance of Screening Employees Against Medicare Exclusion Database
- CMS Guidance on the Role of a Medical Director
- The Changing Definition of Medical Necessity
- Proposed Rule Seeks the Expansion of OIG’s Exclusion Authority
- 2013 Medicare Improper Payments Were $100 Billion!
- Proposed Rule Seeks to Give Expand OIG CMP Authority
- Hospice Providers – New HIS Record Requirements!
- Responding to a Texas Medical Board Complaint
- The Cloud Storage of Medical Records Presents a Number of Risks
- Physician Office OSHA Standards Present a Number of Compliance Challenges
- Medicare Lifts Ban on Coverage for Sex Reassignment Surgery
- Texas H.B. 300 Imposes a Number of New Medical Privacy Requirements
- Miscoded Evaluation and Management Services Cost Medicare $6.7 Billion
- Consequences of HIPAA Non-Compliance
- HIPAA Encryption is the Best Way to Avoid a Violation
- Fed Up Over Burdensome RAC Appeals Process, Hospitals Sue HHS
- Overview of ZPIC Program Integrity Functions.
- New OCR Audits of HIPAA Practices Have Been Announced
- Physicians Warned About Improper DME Marketing Schemes
- The Medicare Care Choices Model will Permit Hospice Palliative and Curative Care
- Electronic Criminal HIPAA Attacks on Protected Health Information Rise 100% In Four Years
- CMS Announces a Pause in RAC Operations
- Texas Providers Are Required by Law to Have a Medicaid Compliance Program
- CMS and Contractors Must Address EHR Fraud Vulnerabilities
- Novitas Reminds us of the Impending ICD-10 Transition Date: October 1, 2014
- CMS Supplemental Medical Review Contractor Audits Texas Providers
- The OIG 2014 Work Plan Has Been Released
- The AHA Argues Fundamental RAC Program Reforms are Needed
- Dermatology Practice HIPAA Breach Results in Settlement with OCR
- High Cumulative Payment Providers are Under the ZPIC Audit Microscope
- EHR Cloning Practices Can Lead to Medicare Audits
- The OIG Strategic Plan for 2014-2018 Has Been Issued
- 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
- The Transition to ICD-10 is a Year Away. Will Your Practice be Ready?
- Improper Medicare Payments Are Still Being Made for Deceased Beneficiaries
- Wake Up Sleep Labs! OIG is Concered About Questionable Billing Practices
- Should You be Concerned About a Consultant Qui Tam?
- Is There a Higher Risk of Audit in Chiropractor-Owned Multidisciplinary Clinics?
- Complying with an Individual’s Request to Restrict the Submission of PHI to Insurance
- Has Your Practice Implemented the Final HIPAA Omnibus Rule Requirements?
- Texas Medical Board Complaints are Serious Business!
- The Physician Payment Sunshine Act is Here — Are you Ready for Full Disclosure?
- Are Your Outpatient Therapy Claims Ready For Manual Medical Review by a Medicare RAC?
- Are Medicare Opt-Out Concerns Overblown?
- Prepayment Reviews and Postpayment Audits are Increasing in Frequency — New Guidance has Been Issued to ZPICs
- Medicare Recognizes Same Sex Marriage and Allows Couples Care in the Same SNF
- Rise of the UPICs – Changes to the Medicare Program Integrity Contractor Landscape are on the Horizon
- Strategic Health Solutions has Initiated an E/M Claims Audit of 99214 and 99215
- When Did You Last Review Your Private Payor Contracts? You Need to Analyze Before You Sign!
- ICD-10 Will be Here Soon. Is Your Practice Ready?
- HHS-OIG Issues New Guidance on the Effects of Exclusion from Participation in Federal Health Benefits Programs
- CMS Issues Instructions on the Impact of Sequestration on Survey and Certification Activities – How Will it Affect Providers?
- Strategic Health Solutions is Merely the Latest CMS Contractor to Flex its Audit Muscles
- Recovery Audit Contractor Changes will be Major in 2014
- Does One of Your Employees Suffer from a Chronic Illness or Medical Condition? Consider the ADA When Assessing Their Request for Additional Medical Leave
- Medicaid and CHIP Audits are Increasing Under the CMS PERM Audit Program
- The CMS Fraud Prevention System is Proving to be an Invaluable Targeting Tool for ZPIC Audits.
- A TMB Complaint is Serious Business — Don’t Take the Texas Medical Board Complaint Process Lightly
- Court Approves Settlement in Jimmo v. Sebelius –- Expands Coverage of Skilled Care.
- The Texas Medical Board Remains Busy Due to High Number of Complaints Filed in 2012
- Texas Licensing Boards Have Announced a Pain Clinic Takedown and Have Disciplined Multiple MDs and PAs
- DME Claims Audits of Back Braces by OIG, MACs, and ZPICs are Likely to Further Intensify
- Congress Extends the Period Permitting Medicare Overpayment Recoveries
- Medicare Exclusion Screening is Essential to Compliance — Failure to Properly Screen Can be Costly
- HIPAA Breach Penalties are Being Assessed for Potential Disclosures of Less than 500 Patients. Have You Taken Steps to Prevent a Breach?
- OIG Report OEI-05-11-00250 — Problems With Medicare’s EHR Incentive Payment Program
- Physicians Being Placed on Non-Random Prepayment Review in Unprecedented Numbers. Are You Ready for an Audit?
- The Recovery Audit Contractor Program Continues to Expand its Medicare Footprint
- OIG Scrutinizes Medicaid Personal Care Services and Issues Report Outlining Vulnerabilities.
- The OIG Identifies Substantial SNF Medicare Overpayments
- The Medicare Audit Improvement Act Appears Promising at First Glance. Is it Really the Answer?
- Is the Secretary for the Department of Health and Human Services Going to Issue an 1135 Waiver?
- Health Systems Brace for Hurricane Sandy
- Settlement in Jimmo Case Would Expand Coverage of Maintenance Skilled Care
- Individual Liability for Medicare Overpayment Claims
- A CMS ZPIC Contract is Quite Lucrative
- FCA Express Certification Liability Theory
- Seven Elements of a Payable Claim are an Essential Tool When Preparing for a ZPIC Audit
- HHS-OIG Finds ZPICs May Have Conflicts of Interest
- Texas Medical Privacy Act Takes Effect
- What Should I Do If I Discover A Breach of PHI?
- Options for Responding if Your Practice is Placed on ZPIC Prepayment Review
- The Government is Actively Investigating Allegations of Hospice Fraud
- Medicare Audits in Miami, FL
- Employing Excluded Individuals Can Cost You!
- CMS To Begin RAC Prepayment Reviews on August 27th.
- Medicare Administrative Appeals Process – An Overview for New Providers
- SNF Prepayment Review by ZPICs are Increasing Around the Country
- Baton Rouge Medicare Audits by CMS Program Integrity Contractors.
- Houston Medicare Audits and Enforcement Actions.
- Choosing the Right ZPIC Audit Appeals Attorney: Who is Best for You?
- Medicare Administrative Contractor Changes — MAC Changes and Update.
- Supreme Court Rules That the ACA is Constitutional
- Healthcare Data Mining Audits: Impact on Medicare Providers and Suppliers
- Social Media and Healthcare: A Little More Complicated
- Duties of Referring and Ordering Physicians
- National Site Visit Contractor Established
- Medicaid RACs to Increase Enforcement Efforts
- Medicaid MIC Audits to Increase
- Medicaid Therapy Services in Texas Must Comply With HHSC Rules
- 100 Involved in Health Care Fraud Arrests
- The Current CMS Initiative on Reducing Hospital Admissions is Here!
- Connolly Posts New Issue for Hospice Billing
- Highmark (MAC Jurisdiction H) Dates Released
- Medicaid RAC Program Up and Running – 26 States Award RAC Contracts
- HIPAA Breach Concerns are Becoming More Serious Each Year
- TrailBlazer Loses MAC Bid Protest
- OMHA Changes ALJ Hearing Case System
- Georgia Prepayment Reviews are Being Conducted by AdvanceMed
- The Physician Payment Sunshine Rules
- CMS Issues Proposed Rules About Returning Medicare Overpayments
- RAC-Initiated Medicare Prepayment Reviews Will Soon Begin.
- CMS is Actively Auditing EHR Incentive Funds
- Are HIPAA Whistleblower Provisions Around the Corner?
- The Senior Medicare Patrol is Here!
- RAC Prepayment Review Delays Will Effectively Place the Project on Hold
- Is a RAC Prepayment Review of Your Medicare Claims on the Horizon?
- A CERT Audit Is Serious – Don’t Take These Medicare Reviews Lightly
- Data Mining is Being Used for ZPICs Targeting Purposes
- CMS’s New Physician Compare Website to Report on Provider Performance
- Conducting a Gap Analysis / Mock Audit: An Essential Compliance Tool for Your Practice
- Maryland Bullying, Cyber Bullying and Hazing Laws
- Ten Recommendations to Improve Medicare Compliance and Prepare for a ZPIC Audit
- The OIG Found that More than Half of All Power Wheelchair Claims Paid by Medicare were Improper.
- Fundamental “Rules of Life” That Also Apply to Medicare Compliance Concepts.
- ZPICs are Conducting SNF Medicare Audits Around the Country!
- Physician Alleged to Have Wrongfully Disclosed PHI is Being Prosecuted
- Texas Physicians and the Texas Medical Board Under HB 680
- Lose Your Appeal at Reconsideration? Consider an ALJ Hearing
- Proposed Medicaid Payment Rates are a Potential Game Changer
- Predictive Modeling: ZPICs Using Data Mining to Identify Medicare Fraud
- NCI-Owned AdvanceMed Will Remain the ZPIC Responsible for Zones 2 and 5.
- ZPIC Audits are Here. When it Rains, it Pours . . . DME Compliance is Essential!
- HHS-OIG Report Signals an Increase in SNF Audits by ZPICs
- The Medicare Administrative Appeal Process
- CERT Postpayment Audits: An Overview of the Audit Process
- Texas Providers Should Expect Increase in Postpayment Audits of E/M Claims.
- Are Medicare ALJs Truly Independent Fact Finders?
- ZPICs Will Deny Claims with “Signature Stamps” and “Date Stamps”
- ZPIC Participation in ALJ Hearings is Increasing
- 2011: The Year of Compliance – Medicare Payment Suspension Actions
- 2011 The Year of Compliance. Avoiding ZPIC Audits and ZPIC 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
- Provider Exclusion Screening / OIG Screening Practices are a Significant Risk
- HHS Publishes Proposed Rules on Medicaid RACs
- “Form I-9” Practices for Health Care Providers
- CMS Authorizes Medicare Appeals by Fax and Secured Internet
- The AHA Expresses its Concerns with Recent False Claims Act Kyphoplasty Cases
- HHS-OIG Issues Report on Improper Claims for Nonemergency Transportation Services
- HHS-ONC Names EHR Certification Bodies
- DOJ is Using Medicare Billing Data to Target Health Care Providers
- Health Data Insights Begins Medical Necessity Reviews
- Region B RAC CGI Announces that it will Begin Review of Eighteen Projects that Involve Medical Necessity
- CMS Issues Medical Record Retention Reminder: MLM Matters SE1022
- President Obama enacts the Improper Payments Elimination and Recovery Act
- Questions to Ask Your Lawyer When Defending an Overpayment Case Where Extrapolation has Occurred.
- South Texas Medicare Providers are Under the ZPIC Microscope
- Providers Should Exercise Caution When Handling Overpayments — More Than Likely, You Can’t Keep It, Even if the Payor Doesn’t Want it Back!
- CMS Has Issued the Final EHR Meaningful Use Regulations
- Can a ZPIC Extrapolate the Alleged Damages in a Medicare Claims Audit?
- ACA Reporting and Repayment Mandates are a Real Minefield for Medicare Providers.
- Enactment of Doc Fix Bill Offers Another Temporary Reprieve for Medicare Physicians
- GAO Testimony Recommends CMS Improve Enrollment, Payment, and Oversight Procedures
- Chief Legal Counsel for OIG Discusses the Impact of the ACA on Enforcement with Congress
- President Obama Publicizes Measures to Reduce Medicare Improper Payment Rate
- Responding to a Search Warrant Executed at Your Health Care Practice or Clinic
- HHS-OIG Reports that Four Medicaid Audit Error Types Accounted For 95% of the Net Improper Medicaid Overpayments
- For AdvanceMed, it’s Not Personal, Just Business – Big Business
- Will More “Bounty Hunters” Be Conducting Medicare Audits?
- Are ZPICs Tougher than RACs or PSCs When Conducting Medicare Audits?
- What is a ZPIC?
- Texas ZPIC Audits in Texas are Increasing – Is There a New Sheriff in Town?
- Category: Compliance
- Exclusion Screening-OIG Screening: The New “Seventh Element” of Compliance.
- OIG And DOJ Issue Important New Compliance Guidance
- OIG Proposes New Anti-Kickback Law Safe Harbors
- Healthcare Providers Aren’t Covered Under the Red Flag Rules
- Under Health Care Reform Legislation, Stark Law Whole Hospital and Rural Provider Exceptions are Changing
- CMS Publishes Stark Self-Disclosure Protocol
- ZPICs and PSCs are Enforcing Strict Medicare Signature Requirements
- Identity Theft — Red Flags Rule — Treating Doctors Like Banks Is Delayed Once Again
- Your Next “Patient” May be an Undercover Agent Performing a Medicare Audit on Your Practice.
- Category: HEAT Strike Force
- Category: Regulatory Issues | Privacy | Other
- Recent Changes to DOJ’s “Justice Manual” Addressing De-Facto Regulations and Agency Guidance Documents
- Is ePHI Encryption Required? The Failure to Properly Protect ePHI Can be Quite Costly
- Sexual Harassment: Cases Against Texas Physicians in 2017
- Looking a Gift Horse in the Mouth (or how to deal with holiday gifts)
- Cell Tower Ground Lease Renewals and Purchases
- Pierce the Corporate Veil-Can Healthcare Owners Be Personally Liable?
- False Claim Act Whistleblower Cases Are Rising
- HIPAA Risks of Breach: Windows XP Will No Longer be Supported by Microsoft
- The HIPAA / HITECH Omnibus Final Rule is Here! Is Your Health Care Organization Complying with the Rules?
- Disability Discrimination Cases are Being Pursued by the Office of Civil Rights
- Enforcement of Alleged Genetic Discrimination is Real – Just Ask the Company Sued by EEOC!
- “Under the Fifth Amendment, You Have the Right to Remain Silent.” Well. . . Maybe Not.
- Record FCA Recoveries Were Collected by the Government in 2012
- Peddling and Soliciting, Municipal Regulations These Issues Can be Complex. Is Your City Clear on These Points?
- What is Civil Fraud?
- Healthcare Cloud Computing – Compliance Risks
- FCA Statute of Limitations Issues
- Be Aware of Business Associate HIPAA Breach Risk Issues.
- Guide to Efficient Business Transactions: Part III
- Guide to Efficient Business Transactions: Part II
- Guide to Efficient Business Transactions: Part I
- AdQIC: A Brief Refresher on the Role This Contractor Plays
- The Latest OIG Report on E/M Coding Finds that Coding Practices are Trending Higher
- Providers Must Ensure that Social Media Practices are HIPAA Compliant.
- NFLPA Collusion Suit Against NFL Alleges Conspiracy
- Contract Basics – What is a Contract? Is Your Agreement Legally Binding?
- Jurisdiction H: Novitas Posts New FAQs and EFT Alerts
- Non-Disclosure Agreement – Checklist for the Recipient of Confidential Info
- Liquidated Damages – Don’t Take a Bath When You Cancel a Contract
- The Supreme Court Reviews the ACA’s Individual Mandate Provisions
- “What Do You Really Owe When a Debt Collector Calls?”
- Data Mining Tools Can Help Identify Possible Problems
- Beware of Small Print – It Can be Bad for Your Wallet
- “There is a Fiduciary Duty Here. It’s Really Inconceivable to Us.”
- HIPAA Audit Protocols are Here. Are Your Privacy Practices Fully Compliant?
- “A Verbal Contract Isn’t Worth the Paper on Which it is Written.”
- Virginia Bullying, Cyber Bullying and Hazing Laws
- Your Child’s Rights Under Section 504 and the ADA
- Implementing an Individualized Education Program (IEP)
- Who Needs a Copy of the Written IEP?
- IEP Placement Must be in the Least Restrictive Environment
- Drafting an IEP
- IEP Related Services
- IEP Team Members Play an Essential Role in the Development of Your Child’s IEP
- The Contents of an IEP are Essential to Its Success
- An Overview of the Special Education Process Under the IDEA.
- Can a School Attorney Attend an IEP Team Meeting?
- Arbitration Provisions in City Contracts
- What You Need to Know Before Signing a Physician Employment Agreement.
- 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 (HOT Funds): What are They? Part I of III.
- White House Issues Executive Order to Improve the Regulatory Process
- HEAT Investigations of Health Care Fraud in South Texas
- Health Care Reform- The Independent Payment Advisory Board (IPAB) And Its Implications on Health Care Providers
- What Can Cities Do About Dangerous Buildings?
- Contracts with Cities 101:
- Mechanic Liens against Public Property
- City / Municipality Statute of Limitations Issues
- Don’t Take ZPIC Extrapolation Calculations at Face Value
- Trade Secret Information Shared with Cities
- President Obama Appoints Dr. Donald Berwick as the New Head of CMS.
- A Look at RACs — Part III: What Medicare Providers Know about RAC Audit Recoupment Rules.
- A Look at RACs — Part II: How Should Physicians and Other Providers Respond to a RAC Audit?
- Part III: Issues When Dealing with a Failed Corporation — Analysis and Conclusion
- Part II: The “Zone of Insolvency” — the Delaware Example
- Part I: The Fiduciary Duties of Officers and Directors of an Insolvent Corporation
- D&O Insurance Coverage: Understanding the Role of Outside Directors
- The Dodd-Frank Act and Major Corporate Governance Reform