In July 1965, President Lyndon Johnson signed legislation enacting Medicare and Medicaid into law [1]. In doing so, he ushered in a new era of Federal health benefits, the size and corresponding expense of which never could have been anticipated at the time of passage. Over the last fifty years, the various laws, regulations and policies governing the Medicare program have become extraordinarily complex. Today, regulatory compliance is more important than ever.
In March 2010, Congress passed comprehensive health care reform measures intended to make health care more accessible, address a wide variety of insurance company practices, improve the quality of care provided and reduce the likelihood of health care fraud, waste and abuse [2]. Referred to as the Affordable Care Act (ACA), these provisions represent the most sweeping health care coverage legislation since the original passage of Medicare and Medicaid, nearly 50 years ago. Today, the coverage and payment rules associated with Medicare, Medicaid and other government health plans are extraordinarily complex. These changes have made regulatory compliance even more challenging. Need help? Liles Parker attorneys are well-situated to guide you and your health care practice through the ever-changing regulatory mandates affecting your company.
Regulatory Compliance Issues Handled by Liles Parker Attorneys
- Eight Elements of a Payable Claim
- “Gap” Analyses of Health Care Practices
- Compliance Program Development and Implementation
- Compliance Training for Clinical and Administrative Staff
- “Mock” Audits of Claims and Services
- Business Practice Analysis and Issuance of Formal Opinion Letters
- Independent Review Organization (IRO) Services
- [1] Medicare and Medicaid were passed as part of Titles XVIII and XIX of the Social Security Act.
- [2] The Patient Protection and Affordable Care Act (Pub. L. 111-148) was enacted on March 23, 2010. It was subsequently amended by the Health Care and Education Reconciliation Act of 2010. These two pieces of legislation, collectively referred to as the “Affordable Care Act,” constitute the most sweeping change to our health care system in decades.
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