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Colin M. McDonald, Assistant Attorney General for the National Fraud Enforcement Division of the Department of Justice, recently announced a plan to prioritize rooting out fraud within the United States. The announcement points to five areas of focus: healthcare...
People often go into nursing because they have a desire to help others. This path can lead to meeting lots of interesting people, and it is not uncommon for those interactions to lead to something more. This can leave a nurse wondering if it is possible to pursue a...
65% of nurses report significant stress and burnout. While short staffing and high patient ratios remain concerns, a national survey of more than 2,600 nurses reveals a less obvious culprit: operational friction. The daily frustrations of inefficient workflows, supply...
Pharmacy owners operate in a highly regulated environment where billing and documentation must align with federal and state rules. Even well run pharmacies can draw scrutiny from Medicare, Medicaid and private insurers when claims data, prescribing patterns or...
Facing a Texas Board of Nursing Informal Settlement Conference (ISC) can be one of the most stressful experiences in your professional career. While preparing what you should do is important, understanding what to avoid is equally critical. A wrong move during your...
Medicare fraud in hospice care has become an increasing focus for government investigators. Understanding common violations can help those who own or invest in these health care organizations avoid costly legal battles. The growing scrutiny of hospice billing...
Health care leaders have long relied on return on investment to guide staffing models, service lines and technology purchases. Increasingly, however, executives and governing boards are recognizing the impact of a failure to remember another important factor: the...
Medicare Advantage plans remain under scrutiny as the Centers for Medicare and Medicaid Services (CMS) continues an aggressive strategy to identify and recoup overpayments tied to risk adjustment practices. Current CMS Administrator Dr. Mehmet Oz has doubled down on...
A Texas Medical Board (TMB) complaint can feel like a state level problem with a state level solution. In reality, it often has federal consequences. Physicians, advanced practice providers and pharmacists sometimes learn too late that a TMB investigation can become...
Physicians and other licensed clinicians are frequently approached with business opportunities like partnerships or ownership interests in ambulatory surgery centers or diagnostic labs. Some are perfectly lawful and can not only lead to financial benefits but also...