Friday, May 12th, 2017

Physicians have been confused about Stark Law and how it applies to them. Some believe the law applies to all fraud and abuse violations, but it is only relevant when it comes to particular healthcare services and Medicare beneficiaries. The law also applies indirectly to referrals of Medicaid beneficiaries, but for simplicity, we will only […]

Friday, May 12th, 2017

There are many advantages to sending your medical reviews to an Independent Review Organization (IRO), from faster turnaround times to accessing more specialty knowledge. Once you have made the decision to use an IRO, it is important to have an understanding of how to get the best results. The following tips can help you get […]

Friday, May 12th, 2017

IRO stands for independent review organization. This type of organization is present in many industries, providing peer review and judgement of a person’s work, production, performance, or related behavior. The use of IROs has become a leading practice in the healthcare industry in the past few years. Using an IRO is a great way to […]

Tuesday, April 25th, 2017

The False Claims Act allows the government to recover losses from private entities that overcharge the government for services. The Obama Administration placed a high priority on fighting healthcare fraud, which has led to numerous investigations and large recoveries against the healthcare industry. In 2015, the administration recovered over 3.5 billion dollars. Qui tam is […]

Monday, February 13th, 2017

Instituting a HIPAA compliance program is only the beginning. Staying HIPAA compliant takes time and commitment. It is critical to review the various departments in your practice and make sure that your policies remain up to date. You may be surprised at how quickly technology evolves and leaves your policies outdated. You may also be […]

Friday, January 20th, 2017

March 21, 2010 was a historic day in American history, as Congress passed legislation entitled “The Patient Protection and Affordable Care Act.” Two days later, President Barack Obama signed the bill into law, providing healthcare to citizens across the United States. Supporters celebrated this first major victory in a long struggle to gain some form […]

Tuesday, November 8th, 2016

Over the years, many pharmacies and pharmacists have been charged with or convicted of Medicare fraud, or for fraud committed on another government program. The truth is that a pharmacy employee can commit fraud too. You may not permit the illegal practice, but if you do not have effective internal controls and compliance programs, then […]

Wednesday, August 17th, 2016

Do you have an employment litigation attorney ready to take your call at any time? Employers are required, by law, to follow ever-changing state and federal employment laws. You want to spend your hard earned profits on building your business instead of paying fines or defending lawsuits. An employment litigation lawyer can help you do […]

Friday, August 12th, 2016

Medicaid fraud costs the American taxpayers millions of dollars every year in fraudulent claims and overcharges. All states are affected by Medicaid fraud. Culprits include large hospitals, pharmacies, medical equipment providers, physician practice groups, and clinics. It is important for everyone in the healthcare industry to understand Medicaid fraud and how Medicaid fraud control units […]

Friday, August 12th, 2016

In the healthcare industry, compliance is something everyone in a hospital should focus on. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) publishes a Work Plan every year that outlines new and ongoing healthcare reviews. This Work Plan is a how-to guide on everything the OIG plans to review, […]