Filling out paperwork is often a tedious, time-consuming process. This is true on both sides of the healthcare system — neither patients nor hospitals or physicians are likely to find joy in filling out the paperwork required by insurance providers. But a failure to...
The National Committee for Quality Assurance (NCQA) has established standards and guidelines for how healthcare facilities should go about credentialing healthcare providers. The process is important for many reasons. Aside from the assurance patients receive high...
The feds are aggressive when it comes to pursuing allegations of healthcare fraud. One of their favorite legal tools to use when building these cases is the False Claims Act (FCA). This law basically states that the feds can go after any business that falsely bills a...
The pandemic has strained an already overworked healthcare system, and no one is feeling it more than the physicians, nurses and supporting staff attempting to provide quality care during these difficult times. Staffing numbers are low and demand is high in an...
The Eliminating Kickbacks in Recovery Act (EKRA) generally prohibits the use of kickbacks and other forms of remuneration for referrals. The law applies to various medical practices, including labs. One of the biggest critiques to the law is the lack of transparency....
The feds have accused the home-based healthcare services providers of billing for laboratory and diagnostic testing from 2010 through 2015 that was not reasonable or necessary for the diagnosis or treatment of an illness or injury. As a result, the government argues...
Federal, state, and local laws guide what pharmacists can and cannot do to serve their patients. Navigating these requirements is not always easy and a violation can result in serious penalties. In addition to penalties from the body that oversees a pharmacist’s...
The feds are coming down hard on anyone that is taking advantage of the COVID-19 pandemic for their own personal gain. They have various tools to help build cases against those that it believes misappropriates funds or otherwise abuses the system, but is EKRA one of...
It often starts with a letter. The state medical board generally notifies physicians of an impending investigation by sending a letter and a request for records. This letter is something to take seriously, even if you are certain the complaint that triggered the...
The United States Attorney's Office of the Eastern District of New York recently announced that a New York doctor pleaded guilty to allegations of fraud. The feds claim the physician violated the law when he misused the Paycheck Protection Program (PPP) and Economic...
