"Nationwide Healthcare Lawyers"
(August 15, 2012): Is this your first time being audited by a Medicare Administrative Contractor (MAC) or a Zone Program Integrity Contractor (ZPIC)? If so, the brief outline below can provide a handy summary of the Medicare appeals process. I. Step 1 – Request for Information: In most instances, a health care provider will receive […]
Medicare Administrative Appeals Process – An Overview for New Providers Read More »
(July 30, 2012): Baton Rouge Medicare audits are on the rise. Here’s a summary of the Medicare contractors who service the healthcare providers and suppliers in Baton Rouse, LA: Baton Rouge Population: 230,139 (2011 Census) Medicare Administrative Contractor (MAC) (Parts A/B): Novitas Solutions LLC (a/k/a Highmark) DME MAC (Region C): CIGNA Government Services Administrators LLC
Baton Rouge Medicare Audits by CMS Program Integrity Contractors. Read More »
(July 20, 2012): The number of Medicare audits in Houston, TX, by “Health Integrity,” the Zone Program Integrity Contractors (ZPIC) assigned to this geographic region is steadily increasing each year. An overview of the Houston, TX, contractors assigned to provide support for Medicare health care providers and suppliers is set out below: Houston Population: 2,145,146
Houston Medicare Audits and Enforcement Actions. Read More »
(July 19, 2012): Choosing the right ZPIC audit appeals attorney to represent your practice is possibly the most important step you can take to protecting your rights during the ZPIC audit and appeals process. Indeed, who your representative is in ZPIC cases can make all the difference in the world. It is not enough to
Choosing the Right ZPIC Audit Appeals Attorney: Who is Best for You? Read More »
(July 5, 2012): Recently, the Centers for Medicare & Medicaid Services (CMS) has done some realignment of its Medicare Administrative Contractor (MAC or AC) jurisdictions for Medicare Parts A and B. In addition, it has actively sought proposals through a competitive bidding process to get the most cost-effective contractors processing Medicare claims. Because of all
Medicare Administrative Contractor Changes — MAC Changes and Update. Read More »
(June 28, 2012): In a landmark case for the healthcare industry, the Supreme Court ruled today that the “individual mandate” provisions of the Affordable Care Act (ACA), colloquially known as “Obamacare,” were indeed constitutional. As such, ACA was largely upheld by the Court. This decision further expands Congress’ legislative powers and maintains some of the
Supreme Court Rules That the ACA is Constitutional Read More »
(June 27, 2012): Healthcare data mining has become quite routine. For instance, in a recent case involving a Missouri psychologist, the provider was indicted and arrested on two counts of healthcare fraud and forgery. At the heart of this case was the fact that the psychologist allegedly submitted claims to Medicare and Medicaid that were
Healthcare Data Mining Audits: Impact on Medicare Providers and Suppliers Read More »
(June 20, 2012): A few weeks ago, you may have heard our Firm present a webinar on “Healthcare Providers and Social Media: Risks to be Considered.” Our article here summarizes some of the more important points of that presentation. As an update, we are detailing some new issues to be taken into account by providers
Social Media and Healthcare: A Little More Complicated Read More »
(May 24, 2012): The Centers for Medicare & Medicaid Services (CMS) is rolling out a new survey initiative, known as the “National Site Visit Contractor” program. In updates to the Medicare Program Integrity Manual released on April 6, 2012 and April 13, 2012, CMS has somewhat quietly introduced the National Site Visit Contractor program, noting
National Site Visit Contractor Established Read More »
(May 23, 2012): Recent efforts by CMS to improve Medicaid audit performance have resulted in procedural changes for Medicaid Integrity Contractors (MICs) and financial incentives for Medicaid Recovery Audit Contractors (Medicaid RACs) to increase their audit efforts and effectiveness. RACs have long been regarded as “bounty hunters” within the Medicare/Medicaid and healthcare provider communities. These
Medicaid RACs to Increase Enforcement Efforts Read More »