"Nationwide Healthcare Lawyers"
Wednesday, November 3, 2021 1 p.m. EST / Noon CST / 10:00 a.m. PST Using PEPPER to Assist You in Analyzing Your Home Health Claims Practices For several years now, CMS has been moving from a broad Probe and Educate program to a more targeted one. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) […]
Wednesday, May 3, 2017 ADRs, Pre-Payment Reviews, Post-Payment Audits and Suspensions – The Impact of these Administrative Enforcement Tools on Home Health and Hospice Agencies Pre-payment reviews are now being conducted by both ZPICs and RACs. While the government has placed some restrictions on their use, contractors continue to exercise great latitude in their scope
2017 TAHCH Webinars Read More »
Wednesday, November 6, 2019 The Importance of Incorporation and Asset Protection for Home Health and Hospice Agencies Unfortunately, sometimes even your best efforts are insufficient to keep an organization solvent. If your third-party billing company or your practice is forced into bankruptcy, can you be held liable? Are your personal assets at risk? What impact
2019 TAHCH Webinar Read More »
(January 26, 2021): Under the Anti-Kickback Statute (Anti-Kickback Statute), what constitutes a referral? Notably, neither the term referral nor the term referring (as it is referred to in the law) are defined in the statute. While you may be tempted to argue that a referral only occurs when one party refers a beneficiary to another party
What is a Referral Under the Anti-Kickback Statute? Read More »
Robert W. Liles has worked in regulatory compliance as a Federal prosecutor and as defense counsel, for more than 25 years. This has provided a unique perspective on the challenges faced by clients in highly regulated industries such as health care, banking and finance. Mr. Liles focuses his practice on fraud defense, internal audits, investigations,
Robert W. Liles, J.D., M.B.A., M.S. Read More »
Ashley Morgan is a partner at Lliles Parker. She focuses her practice on regulatory health care compliance matters, fraud and abuse, and reimbursement issues. Ms. Morgan represents health care providers across the country in connection with a wide variety of health law issues including coverage disputes, documentation concerns, compliance, medical board complaints, and exclusion /
Ashley Morgan, J.D. Read More »
The most severe administrative sanctions available under the Social Security Act stems from the authority of the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) [1] to “exclude” individuals and entities from participating in Federal health care programs. Indeed, an OIG Exclusion [2] imposed by the OIG is
OIG Exclusion Actions — Mandatory and Permissive Exclusion Authorities Read More »
(Updated December 2020): Of the many contractors working for the Centers for Medicare and Medicaid Services (CMS), Unified Program Integrity Contractors (UPICs) are by far the serious financial threat to your practice, home health, hospice or DME company. A UPIC audit is serious business. Simply put, the UPIC program was intended to consolidate the work
A UPIC Audit is Serious Business — Is Your Office Prepared? Read More »
(March 30, 2020): The COVID-19 pandemic is unprecedented and has resulted in President Trump declaring a National Emergency[1] and Secretary Alex Azar, of the US Department of Health & Human Services (HHS) to declare a public health emergency[2] for the nation. The effects of this pandemic have been felt across the country, and understandably, numerous
Operating a Medical Practice in Texas during the COVID-19 Pandemic Read More »
(March 26, 2020): The Small Business Administration (“SBA”) announced an Express Bridge Loan Pilot Program on March 25, 2020.[1] The Express Bridge Loans are available to businesses, including health care providers, to provide economic relief for businesses impacted by the Coronavirus Disease (COVID-19) while they await long-term disaster financing.[2] I. Background: The Express Bridge Loan
Small Business Administration Releases Express Bridge Loan Pilot Program for COVID-19 Read More »
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