"Nationwide Healthcare Lawyers"
(June 16, 2014): It has been over a year since the effective date of the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) comprehensive modifications to the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, Enforcement and Breach Notification Rules, commonly referred to as the Omnibus Rule. Covered entities were […]
Consequences of HIPAA Non-Compliance Read More »
(February 21, 2014): If you are a participating provider in the Texas Medicaid program, do you have a Medicaid compliance program in place for your practice? If the answer to this question is “no” – or, more worrisome, if you are asking, “What is an effective compliance program?” – you are violating the terms of
Texas Providers Are Required by Law to Have a Medicaid Compliance Program Read More »
(February 7, 2014): A new report from the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) finds that the Centers for Medicare and Medicaid Services (CMS) and its contractors have adopted few Medicare program integrity practices to address electronic health record (EHR) fraud vulnerabilities. These EHR fraud vulnerabilities include
CMS and Contractors Must Address EHR Fraud Vulnerabilities Read More »
(February 6, 2014): Before a Medicare beneficiary may be deemed eligible for home health services, a provider must perform a face-to-face encounter with the patient and certify that he or she is eligible for care. More importantly, the certifying physician must properly document this encounter. However, practitioners are commonly finding that their documentation do not
Home Health Face-to-Face Encounters: Is Your Agency Performing it Properly? Read More »
(January 3, 2014): A 57-year-old Queen City, New Hampshire dentist has recently been charged with 189 counts of Medicaid dental fraud. As a result, he could face many years in prison. The New Hampshire Medicaid program is a joint federal and state-funded health care program that serves individuals and families in that state who meet
Dentist Indicted on Nearly 200 Counts of New Hampshire Medicaid Dental Fraud Read More »
(December 26, 2013): The Department of Health and Human Services (HHS) has long viewed the adoption of Electronic Health Records (EHRs) as a way to better coordinate care, improve the quality of care, reduce unnecessary paperwork, and eliminate duplicative medical testing. Based, at least in part, on these beliefs, Congress authorized incentive payments to encourage
EHR Cloning Practices Can Lead to Medicare Audits Read More »
(December 23, 2013): A recent state audit of a Massachusetts dentist has reportedly uncovered numerous instances of MassHealth dental fraud, alleging that dentist fraudulently billed the state’s “MassHealth Insurance Program”. According to the state’s auditor, the dentist “systematically bilked the MassHealth Dental Program”. In all, the audit claims to have found over $150,000 in improper
Dentist Alleged to Have “Systematically Bilked” MassHealth Dental Fraud Scheme Read More »
(December 4, 2013): Generally, Medicare does not cover hospital outpatient dental services. Under the general exclusion provisions of the Social Security Act, items and services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting the teeth (e.g., preparation of the mouth for dentures or removal of diseased teeth
Hospital Outpatient Dental Services are Being Audited Read More »
(November 20, 2013): While most health care providers and suppliers are diligent in their efforts to ensure that Medicare services are submitted appropriately, mistakes and other improper billings still take place. Two areas of continuing concern involve providers and / or suppliers who submit fraudulent claims to Medicare seeking reimbursement on behalf of deceased beneficiaries
Improper Medicare Payments Are Still Being Made for Deceased Beneficiaries Read More »
(November 11, 2013): TSBDE Update – The Texas Legislature first provided for licensure of dentists in 1897, whereby district judges were empowered to appoint a Board for their districts consisting of three practicing dentists living in the district. In 1905, Senate Bill 84 created the Texas State Board of Dental Examiners (TSBDE or Board). The
TSBDE Update: Texas State Board of Dental Examiners Read More »