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The United States Centers for Medicare and Medicaid Services (CMS) defines a Medicare overpayment as one that exceeds a regulation and statute properly payment amount. Additional issues arise if the feds can establish that the provider was aware of the overpayment....
Due diligence is important when looking to purchase a healthcare group. Whether looking at an entire facility or an individual private practice, it is important to ask the following questions before moving forward with a deal. #1: What are the financials? Get the...
The coronavirus pandemic has led officials to make changes to regulations that impact nurse licensure. Some changes impact operations, others impact legislation. The medical community describes some of these changes as long-overdue updates while others were simply a...
Healthcare organizations with delegation agreements with private or government insurance programs are wise to prepare for, at a minimum, audits on an annual basis. Insurance providers use these audits to better ensure the healthcare business complies with the...
New York officials recently arrested a local pediatric surgeon. The officials state they caught the medical professional attempting to illegally sell opioids. The physician, who also serves on an opioid task force, faces up to nine years imprisonment for the charges....
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has increased its focus on healthcare fraud schemes involving telehealth services. The OIG began this increased focus in 2016. These efforts contributed to a massive takedown in...
Government enforcement efforts have proven successful with yet another Health Insurance Portability and Accountability Act (HIPAA) case. In this most recent case, the Office for Civil Rights (OCR) settled with a New York spinal group over allegations the group failed...
The Centers for Medicare and Medicaid Services (CMS) oversees the Hospital Readmissions Reduction Program (HRRP). Lawmakers developed this program to help better ensure the provision of quality, value-based care. To help achieve this goal, the HRRP reviews...
The Health Insurance Portability and Accountability Act (HIPAA) applies to sensitive patient health information. Medical practitioners are wise to understand how this federal law impacts their practice. Three important facts about this law include: #1: Not everyone is...
A 73-year-old surgeon recently filed a case against his former employer. He claims hospital officials discriminated against him based on his age when they had him undergo a neuropsychological and physical exam as well as have a proctor present when he conducted...
