Texas Health Care Law Blog

Difficult patient issues perplex every provider

Providers report an increased number of problems with challenging patients.

These are the patients, or their family members, who become angry, raise their voices and make up their minds early in the interaction that you are not competent, or you are disrespecting them, or you are only after their money.

How can improper Medicare claims affect your practice?

The health care industry comes with stacks of government paperwork necessary for regulatory compliance. You can easily feel like you are drowning in forms, and rush to complete them. Unfortunately, hurrying through government forms, such as those required for Medicaid and Medicare claims, can lead to serious errors and consequences.

Common errors include: filling in the wrong procedural codes, listing the wrong medications or including equipment that was not used on a patient. Are you aware that even innocent mistakes can lead to serious Medicare and Medicaid fraud, or even criminal charges?

CEO culpability in the health care industry

Many business executives believe that building a great organization starts at the top. For chief executive officers, this means fostering an environment that is both ethical and profitable. Since the passage of the Affordable Care Act in March 2010, the health care industry has been at the crux of this balance, with new laws meaning increased scrutiny from a variety of media and government organizations.

As the saying goes, with great power comes great responsibility, and business executives are among the first to feel the effects of this adage, both good and bad. Since the crisis of the banking industry in 2008, CEOs have quickly felt the public pressure to come clean on a variety of business practices.

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What To Do When Being Investigated By the Medical Board

Not every board complaint is investigated, but those that are can have a grave impact on your medical license and your livelihood. For physicians who are facing a medical board investigation, it is crucial to take the proper steps to defend yourself against sanctions, license revocation, and more.

Defining "Advertising" and "Referrals" in the Healthcare Industry

It is often necessary for healthcare professionals, pharmacies, home health care agencies, and DME businesses to advertise. In doing so, these businesses need to proceed carefully with how they compensate their marketers-especially when dealing with clients who are covered by federal or state-provided healthcare (like Medicaid, Medicare, etc.). Toxicology labs, for example, where the medical work, supplies, and other transactions is easily quantifiable and documented, require vigilance on this front to ensure that you and your business do not violate the federal Anti-Kickback Statute.

Risks Involved with Physician Ownership of Toxicology Labs

The laboratory industry is undergoing heightened medical scrutiny, both for independent clinical laboratories and physician office laboratories. Expansion into this industry is filled with regulatory risk for violation of state or federal laws. Some of the issues being scrutinized are as follows:

Medicare & Medicaid to Pay Hospices $160 Million More in 2016

Last week, The Centers for Medicare & Medicaid Services (CMS) published a final rule that will change the way hospices are paid in 2016. In the final rule announced in Federal Register, 80 Fed. Reg. 47142, hospices will receive approximate $160 million more in payment over the 2016 fiscal year.

What to Look for When Buying a Home Health Agency

Home healthcare is a growing industry in our country. As we are seeing record numbers in our population enter the advanced stages of their life, the demand for quality medical care in the home is on the rise. For businesses, this trend poses an opportunity for investment and growth with thepurchase of a home health agency (or HHA).

Aggressive Federal Targeting of Medical Fraud Likely to Rise

According to a new report from MD News, 2014 saw a significant rise in federal action against medical fraud and abuse perpetrated by physicians. The trend represents the FBI and Department of Justice's renewed focus in targeting both physicians and large healthcare organizations and is expected to continue to rise for the next few years.

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