"Nationwide Healthcare Lawyers"
(June 29, 2010): In Part I of this series, we reacquainted you with the design and purpose of the now permanent Recovery Audit Contractor (RAC) Program. Although RACs largely focused on inpatient care during CMS’ demonstration program, RACs are a real threat to small providers that don’t have the intensive compliance programs in place that […]
(June 28, 2010): On Friday, June 25, 2010, President Obama signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (H.R. 3962), commonly referred to as the Doc Fix, which provides yet another band-aid for our broken Medicare physician pay system. The bill replaces the 21% Medicare physician payment
Enactment of Doc Fix Bill Offers Another Temporary Reprieve for Medicare Physicians Read More »
(June 25, 2010): The purpose of this series of articles is to assess the Recovery Audit Contractor (RAC) Program from the perspective of physicians, home health, hospice, durable medical equipment (DME) providers, and other relatively small Medicare providers. As many non-hospital providers will acknowledge, early cries of wolf by law firms and consultants did a
(June 8, 2010): For those of you who missed the first two dozen pronouncements (okay, perhaps a little exaggerated, but still . . . we got the message when Congress made it a False Claims Act violation to hold onto a mere overpayment for more than 60 days), President Barack Obama has again expressed his
President Obama Publicizes Measures to Reduce Medicare Improper Payment Rate Read More »
(June 1, 2010): Like most honest health care providers, you may believe that search warrants are only executed by the government in connection with the investigation of nefarious characters and criminals. Unfortunately, that just isn’t the case. The Federal government has increasingly utilized search warrants as a first-strike investigative tool. In fact, the execution of
Responding to a Search Warrant Executed at Your Health Care Practice or Clinic Read More »
(April 10, 2010): As the American Medical Association (AMA) recently reported on March 22nd, 2010, health care providers may find themselves subjected to a Medicare Secret Shopper audit by fellow health care providers and others hired by the government to conduct undercover reviews and investigations. In a speech he made March 10th, 2010, President Obama
(April 3, 2010): The Federal government is taking considerable steps to stop Medicare fraud and abuse. Notably, the number of publicly-disclosed HEAT Strike Force investigations and prosecutions in Texas significantly increased last month. Two of the cases disclosed involved mental health professionals: A Psychologist was convicted of health care fraud and money laundering, in connection
HEAT Strike Force Update: Prosecutions in Texas Increased in March 2010 Read More »
(March 26, 2010): Over the next few days, we will be publishing a brief overview of specific Zone Program Integrity Contractors (ZPICs) (such as AdvanceMed) – the companies who have been hired by CMS to conduct the medical reviews of Part A and Part B health care providers around the country. As we have previously
For AdvanceMed, it’s Not Personal, Just Business – Big Business Read More »
(March 25, 2010): Yesterday, the White House announced that President Obama intends to back additional bipartisan plans to stamp out waste in government-run medical programs for the elderly and needy. The White House said this new effort, which is being called nothing more than another bounty hunter program by its critics, is intended to root
Will Another Bounty Hunter Be Conducting Medicare Audits? Read More »
(March 16, 2010): Health care providers around the country are finding themselves the target of various audits from jurisdictionally overlapping Medicare contractors. Notably, any of these audits have the potential to destroy a provider’s practice or clinic. States where PSCs (Program Safeguard Contractors) have transitioned to ZPICs (Zone Program Integrity Contractors) are under extreme pressure.
Texas ZPIC Audits in Texas are Increasing – Is There a New Sheriff in Town? Read More »
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