"Nationwide Healthcare Lawyers"
(September 16, 2014): Consider the following scenario. You own a durable medical equipment (DME) company that you run out of a leased location in a local office building. Your customers are a mix of privately insured and Medicare/Medicaid beneficiaries. You’ve been in business for about 10 years, but money is tight and you need to […]
Medicare Revocation Action: Steps for Avoiding and Appealing Read More »
(October 19, 2012): This article addresses the case where an individual or “natural person” owns an interest in a Medicare health care provider which is incorporated[1] under the laws of a state, as a corporation, limited liability company, limited partnership, or another type of legal person. The individual may be a shareholder, member, limited partner,
Individual Liability for Medicare Overpayment Claims Read More »
(February 7, 2012): In recent years, physicians and other health care providers have faced a wide number of administrative actions and sanctions levied by contractors working for the Centers for Medicare and Medicaid Services (CMS). Zone Program Integrity Contractors (ZPICs) have subjected physician practices to Medicare prepayment reviews, postpayment audits, suspension and / or revocation
RAC-Initiated Medicare Prepayment Reviews Will Soon Begin. Read More »
(January 20, 2012): The Department of Health and Human Services (HHS) has long used reports and complaints from affected patients to further conduct Medicare audits of possible Medicare fraud, waste and abuse. Last June, it was reported that HHS was planning on implementing a “Mystery Shopper” program, with a Federal contractor posing as a potential
The Senior Medicare Patrol is Here! Read More »
(July 24, 2011): Has your Texas physician practice, home health agency, hospice, DME company or PT / OT / ST clinic been audited by a Zone Program Integrity Program (ZPIC)? If not, it may only be a matter of time. Despite your best efforts to follow Medicare’s directives, your organization may still be identified as
Ten Recommendations to Improve Medicare Compliance and Prepare for a ZPIC Audit Read More »
(January 11, 2011): ZPIC audits and ZPIC suspension actions are a serious risk facing non-hospital providers today. As you recall at the end of 2010 we identified the “Top Ten Health Care Compliance Risks for 2011”. The purpose of this article is to analyze two of those risks; Zone Program Integrity Contractor (ZPIC) audits and
2011 The Year of Compliance. Avoiding ZPIC Audits and ZPIC Suspension Actions Read More »
(March 25, 2010): The Recovery Audit Contractor (RAC) program is an integral part of the Centers for Medicare & Medicaid Services’ (CMS’) “benefit integrity” efforts which seek to identify and recoup alleged overpayments paid to Medicare providers. Similarly, Program SafeGuard Contractors (PSCs) have been actively auditing Medicare providers and suppliers around the country. While the
Is a ZPIC Tougher than a RAC or PSC When Conducting Medicare Audits? Read More »
(October 3, 2022): Aquatic therapy is a common method of rehabilitation and maintenance for several types of injuries and conditions, and the practice is widely accepted by Medicare, Medicaid and many private payors. Historically, both payors and law enforcement have routinely audited aquatic therapy claims. The Centers for Medicare and Medicaid Services (CMS) initially suspended
Enforcement Efforts Targeting Aquatic Therapy Providers and CPT Code 97113 Claims Read More »
Liles Parker attorneys have decades of experience practicing health care law. Several of our attorneys served as Federal prosecutors and held significant positions at the U.S. Department of Justice. Our health care transactional and regulatory attorneys have the knowledge and counseling skills necessary to efficiently resolve your health care business issues at the lowest possible
Healthcare Law Representation Read More »
(April 12, 2018): The Centers for Medicare & Medicaid Services (CMS) utilizes a variety of private contractors to process Medicare claims and conduct both administrative and program integrity audits of claims submitted by healthcare providers and suppliers. At the present time, CMS has contracted with eGlobalTech (eGT) to analyze data and prepare “Comparative Billing Reports”
CBRs for Spinal Orthoses (CBR201803): What Do You Need to Know? Read More »
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