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Articles Posted in Medicare Fraud

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Post 2 of 2: The Pretrial Diversion Program in Georgia: Answering Questions Relating to the Offense

This is the second post in a series related to the Pretrial Diversion Program in Georgia.  The first post provided an overview of the Pretrial Diversion Programs in Georgia and the potential impact on a successful participant’s criminal record.  This post focuses on how successful completion may impact a participant’s…

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Post 1 of 2: The Pretrial Diversion Program in Georgia: An Overview

Our healthcare and business law firm works with many providers and other professionals who have been arrested and charged with misdemeanors.  Our clients will, of course, hire criminal defense counsel to handle the criminal proceedings but professionals generally hire our firm navigate the professional consequences of an arrest.  Many of…

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3 Tips if You’re Facing an Insurance Audit

Many of our healthcare and business law firm’s clients periodically face audits by insurance companies or governmental organizations, usually through a contractor.  Audits can be unnerving times for a practice to go through.  This blog post outlines 3 tips for handling an insurance audit.  The Centers for Medicaid and Medicare…

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The Anti-Kickback Statute’s Rules on Per-Use or Per-Click Rental Equipment Leases

Many of our healthcare and business law firm’s clients are in the business of renting expensive medical equipment for use by medical practices.  Generally, these arrangements raise compliance questions under the Physician Self-Referral Act, referred to as Stark Law, and the Anti-Kickback Statute (“AKS”).  Should a regulator find an arrangement…

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Stark Law’s Rules on Per-Use or Per-Click Rental Equipment Leases

Many of our healthcare and business law firm’s clients are in the business of renting expensive medical equipment for use by medical practices.  Generally, these arrangements raise compliance questions under the Physician Self-Referral Act, referred to as Stark Law, and the Anti-Kickback Statute (“AKS”).  Should a regulator find an arrangement…

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NAVIGATING THROUGH A CMS PAYMENT SUSPENSION- UPIC AUDITS

About 20% of United States tax dollars are spent on heathcare.  Naturally, reducing improper payments has been a priority of CMS. Thus, all medical practice managers and healthcare providers should be aware of CMS’s process of contracting with Uniform Program Integrity Contractors (UPIC’s), private entities hired by CMS to audit…

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AseraCare Settlement with DOJ A Win for Hospice Providers Under Federal False Claims Act

In a landmark federal False Claims Act case closely watched for many years by hospice administrators, other healthcare providers and legal experts, last week the Department of Justice (DOJ) entered a joint dismissal in settlement of the case against AseraCare Inc., a national hospice provider company.  The settlement marks an…

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Time For Change: Potential Modification To Federal Healthcare Laws May Allow For Better Care Coordination Between Providers

As technology improves the ability for providers to communicate, existing healthcare laws will continue to be put to the test. Now, a new call for care coordination is driving quality improvement initiatives for physicians and hospitals. In 2018, U.S. Department of Health and Human Services (HHS) launched its initiative “Regulatory…

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When A Doctor Needs a Lawyer: Fraud Investigations – Avoid Becoming the Next Headline

Healthcare fraud attributable to nurses, hospitals, pharmacists, equipment providers and doctors, contributes to the high cost of medical care. For this and other reasons, fraud continues to be a hot topic in the healthcare industry. Recently, there have been numerous headlines regarding Medicare, Medicaid, and private insurance company investigations of…

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When a Doctor Needs a Lawyer – Patient Referrals for Imaging: Staying Compliant with the Law

Legislation controlling self-referrals has created a complex road map that can leave doctors with questions regarding their ability to use business agreements to promote lab work and advanced imaging technology for their patients. For physicians, the rules and regulations of self-referrals for imaging can create headaches and lead to fines.…

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