"Nationwide Healthcare Lawyers"
(June 29, 2017): It has been estimated that from 1999 to 2014, more than 165,000 persons died from an overdose of opioid medications in the United States. Researchers also noted that during this same time period, sales of opioids increased in proportion to the rise in deaths resulting from an opioid-related overdose. In an effort […]
Opioid Prescribing Practices & NBI MEDIC / UPIC / ZPIC and Board Actions Read More »
(June 28, 2017): The Medicare program is enormous. As of 2016, more than 56 million individuals participated in the program, with more than 10,000 additional individuals enrolling in the program each day. The Centers for Medicare and Medicaid Services (CMS) is the agency responsible for managing this costly program. To direct this $640 billion program,
NBI MEDIC Referrals to Boards, OIG and DOJ are Here! Read More »
(June 23, 2017): Opioid audits of the prescribing practices of pain management physicians are on the rise. As the Department of Health and Human Services (HHS), Office of Inspector General (OIG), noted in its report “High Part D Spending o Opioids and Substantial Growth in Compounded Drugs Raise Concerns,” 30% of Medicare beneficiaries have at
UPIC / ZPIC / Health Integrity Opioid Audits and Audits of Other High Risk Drugs. Read More »
(June 21, 2017): Over the last year, the False Claims Act penalties have almost doubled. This is especially important when you consider the fact that the False Claims Act is the primary civil enforcement tool used by the U.S. Department of Justice to fight fraud committed against government programs by individuals and entities. Often referred
False Claims Act Penalties Have Almost Doubled! Read More »
(Updated March 20, 2020): Historically, the Centers for Medicare and Medicaid Services (CMS) has relied on a network of private contractors to handle the program integrity functions for both the Medicare and Medicaid programs. Over the years, these private contractors have taken on increasingly significant roles in the detection and audit of instances of fraud,
UPIC Claims Audits of Medicare Services are Underway! Are You Ready? Read More »
(June 5, 2017): Despite the fact that only three treatment services are covered by Medicare, the number of Medicare chiropractic audits conducted by the Department of Health Human Services (HHS), Office of Inspector General (OIG), has remained high over the last decade and is anticipated to grow throughout 2017 and 2018. As you are aware,
Medicare Chiropractic Audits are Increasing! Read More »
(May 26, 2017): Over the past decade, the number of patients utilizing one or more complimentary or alternative care modalities has steadily increased. As patient demand for such services has grown, the percentage of payors including acupuncture in their plans as a covered service has also increased. For over a decade now, most private payor
Private Insurance Payors are Aggressively Conducting Acupuncture Audits Read More »
(May 17, 2017): Exclusion screening-OIG screening duties are now more important than ever before! The recently issued Resource Guide for Measuring Compliance Program Effectiveness” a product of Office of Inspector General staff and compliance professionals roundtable discussions, reconfigures the traditional “Seven Elements of an Effective Compliance Program” by making the “Screening and Evaluation of Employees, Physicians,
Exclusion Screening-OIG Screening: The New “Seventh Element” of Compliance. Read More »
Compliance Guidance (April 14, 2017) Recently, the Office of Inspector General of the United States Department of Health and Human Services (OIG) and the Criminal Division of the Fraud Section at the United States Department of Justice (DOJ) have issued guidance on measuring the effectiveness of corporate compliance programs. In February, DOJ placed on its
OIG And DOJ Issue Important New Compliance Guidance Read More »
(March 17, 2017): The Centers for Medicare and Medicaid Services (CMS) recently announced that it will be initiating its next round of CMS revalidation requests to all Medicare enrolled providers and suppliers. Current law and regulations require providers and suppliers to revalidate their enrollment with Medicare every five years (every three years for DME suppliers).
Are you Ready for the Next Round of CMS Revalidation? Read More »
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