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17 Aug 2019, 11:56 am
The Dangers of Billing Payors for the Services of a Non-Credentialed Dentist / Non-Participating Dentist (August 17, 2019): Over the last year, we have seen a significant increase in the number of Medicaid and private insurance audits of dental claims. [read post]
20 May 2018, 2:26 pm
Medical Records §§165.1-165.6.[3] B. [read post]
26 Jan 2018, 9:43 am
The Federation of State Medical Boards defines physician sexual misconduct as: “[B]ehavior that exploits the physician-patient relationship in a sexual way. [read post]
20 May 2018, 2:26 pm
Medical Records §§165.1-165.6.[3] B. [read post]
5 Oct 2022, 4:11 am
B. [read post]
9 Mar 2020, 10:26 am
42 CFR Sec. 424.535(a) Medicare Revocation Actions — Your Medicare Billing Privileges Can be Revoked For a Host of New Reasons. [read post]
25 Mar 2020, 3:41 pm
Section 1135(b)(1)(C) allows for a waiver or modification of pre-approval requirements if prior authorization processes are outlined in detail in the State Plan for particular benefits Require fee-for-service providers to extend pre-existing authorizations through which a beneficiary has previously received prior authorization through the termination of the emergency declaration These are examples of the types of flexibilities that a state / territory can request but is not all… [read post]
6 Apr 2015, 6:00 am
By Jim Liles and Melanie Martin-Jones In trademark infringement litigation, the critical and usually pivotal issue is whether there is a likelihood of confusion between two allegedly similar marks. [read post]
20 Nov 2023, 10:19 am
B. [read post]
10 Oct 2022, 5:01 am
Civil Investigative Demands (CIDs) & Collateral Enforcement Risks: A Review (October 12, 2022): The False Claims Act is the primary civil enforcement tool utilized by our government today. [read post]
18 Sep 2019, 2:08 pm
Medicare, Medicaid and CHIP Enrollment Revocation and Denial Authorities Have Expanded. [read post]
10 Oct 2023, 10:51 am
During FY 2022, the Centers for Medicare and Medicare Services (CMS) has estimated the Medicare Part B improper payment rate as 8.41%. while the improper payment rate for Durable Medical Equipment (DME) suppliers was estimated to be 25.24%.[2] Additionally, the Medicaid program improperly paid $80.6 billion in improper claims during FY 2022.[3] Notably, these estimates don’t even take into account the sizeable improper billings submitted to private payors. [read post]
15 Sep 2020, 12:09 pm
§ 1320a–7b(b)). [read post]
18 Sep 2019, 2:08 pm
Medicare, Medicaid and CHIP Enrollment Revocation and Denial Authorities Have Expanded. [read post]
22 Dec 2023, 2:31 pm
B. [read post]
12 Aug 2022, 4:24 am
Law Enforcement Has Initiated Medicare Audits of Amniotic Liquid / Amniotic Tissue / Skin Substitute / Wound Care Claims: UPIC Audits of Original Medicare Part B Amniotic Tissue / Skin Substitute / Wound Care Claims. [read post]
8 Oct 2019, 2:00 pm
What is the CMS Preclusion List? [read post]
23 Mar 2020, 1:28 pm
” (Emphasis added.)[7] B. [read post]
12 Apr 2012, 5:00 am
Liles B. [read post]
28 Dec 2020, 10:19 am
A Look Back at Hospice Audits and Prosecutions in 2020 — Are You Ready for 2021? [read post]
