Healthcare is an extremely regulated industry. Programs like Medicaid and Medicare face tough scrutiny from regulators intent on stopping abuse and fraud. Organizations found guilty of fraudulent activity face harsh penalties, even though the regulations and laws in...
Over the past two decades, the U.S. has tried to curb fraudulent health care provider Medicare claims through greater oversight. Prepayment audits are one method that the government has begun using to prevent reimbursement for faulty claims. Unfortunately, if...
Revocation of Medicare and Medicaid contracts can significantly damage your practice and affect your ability to operate in your field. It is crucial to understand your appeal rights to avoid the potential issues that can result from revocation. The initial steps of a...
As a health care provider accepting Medicaid, there are times you may have received an overpayment. It is a common issue that you can remedy with a refund. However, missing an overpayment and not correcting the mistake may lead to the government subjecting you to a...
Even honest billing mistakes can lead to devastating effects for a health care provider. Take overbilling for example. Health care providers occasionally receive overpayment for Medicare or Medicaid. These issues can easily be resolved with a refund. Unfortunately, if...
Doctors are extremely busy. In addition to caring for their patients, regulations force healthcare providers to fill out seemingly endless paperwork. Medicare Parts A and B healthcare providers face the additional burden of ensuring, at risk of punishment, that all of...
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...
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...
