Healthcare businesses, like any other business, often switch hands. Sometimes one business buys out the other and in other situations it may be a merger. Whatever the details of the transaction, it is important for those involved to keep in mind that a healthcare...
Year: 2022
Can my healthcare business regain its Medicare contract?
Private practices, dentist offices, hospitals, any facility that offers medical services may be eligible to bill Medicare for these services. But what happens if there is an issue with the billing procedure? What if that issue snowballs to the point where Medicare...
I am looking at buying a clinic in Texas. What should I know?
Healthcare merger and acquisition deals can provide multiple opportunities for financial growth. Healthcare is generally a stable and often growing market, so investments tend to pay off. But how can you better ensure that your deal pays off? First, figure out how...
DOJ tries to thwart healthcare merger
There are all sorts of hurdles to overcome when working through healthcare mergers. In a recent example, the Department of Justice (DOJ) filed a lawsuit to stop a merger between UnitedHealth Group and Change Healthcare. Talk about a hurdle. More on the players...
Kickback or legit payment? The answer can mean the difference between freedom and prison time.
Officials throughout the country continue to crackdown on potential healthcare fraud cases. The primary motivator is one of the oldest and strongest: money. The feds get billions back from healthcare fraud cases every year. How do these cases work? The government is...
For better or worse, nurses live in a fishbowl
The saying about living in a fishbowl holds true for nurses. Those who are in this profession will often find that the public often view them from all sides, taking both their personal and professional lives into account when seeking care. In some cases, this will...
Texas doctor called “worst medical fraudster” to face sentencing this week
What type of case leads the government to call a rheumatologist one of the worst criminals when it comes to health care fraud? According to the U.S. Attorney for the Southern District of Texas, one that prescribes chemotherapy treatment for rheumatoid arthritis. The...
Court cracks down on personal service safe harbor
The Anti-Kickback Statute (AKS) makes it illegal to encourage referrals for Medicare services in exchange for renumeration or other types of payment. There are some exceptions, referred to as safe harbors. One example is the personal services and contracts safe...
Common mistakes in Medicare overpayment cases
Allegations of a Medicare overpayment are not uncommon. The government estimates that it overpays millions in Medicare claims to physicians and healthcare providers every single year. The government states these overpayments are of the result of a place-of-service...
What steps should I take after I get a Medicare overpayment notification?
The Department of Health and Human Services (HHS) recently announced that it is digging into risk adjustment tactics it claims may have led to overpayments. The review will focus specifically on certain Medicare Advantage (MA) plans. Secretary Xavier Becerra noted the...