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Feds recently accused a physician practicing at a family medicine and aesthetics group in Jefferson County, Texas of partaking in a healthcare fraud scheme. Government officials stated the doctor would prescribe medications, such as scar creams, without the patient’s...
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....
Private equity firms continue to grow their presence within the healthcare industry. We have a number of posts discussing this trend, touching on how to navigate these transactions as well as potential benefits and risks. A recent case explores the risk, looking into...
The United States Department of Health and Human Services (HHS) recently announced it will invest $6.5 million into two commercial diagnostic labs. The agency has stated it expects the labs, one in Nashville, TN the other in Austin, TX, to use the funds to boost...
The telehealth market has thrived during the current coronavirus pandemic. This platform allows physicians to meet with patients while maintaining social distancing, a practice that can be beneficial to all involved. Health insurance companies often cover these...
The Centers for Medicare and Medicaid Services (CMS) have a new rule that allows a more proactive approach to enforcement efforts. Lawmakers wrote the rule to provide another tool against health care fraud. According to the Federal Register, the Program Integrity...
The United States Centers for Medicare and Medicaid Services (CMS) investigates hospitals throughout the country to check for compliance. A poor investigation can result in serious ramifications, including the inability to receive funding through CMS. These...
The government has been very clear on its take on the current opioid crisis. It is coming down on medical professionals that do not follow regulations when prescribing these medications and pushing for serious penalties. In one recent case, the government was able to...
The United States Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS) recently announced a change to the appeals process. The changes will impact Medicare beneficiaries, providers and suppliers. Why the change? The agency...
The Eliminating Kickbacks in Recovery Act of 2018 (EKRA) is part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT). This new law will go into effect in October. One specific point to note...