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Compliance

Compliance

Overtime rule

3 Facts Help Medical Practices Prep for the New Overtime Rule

A new employment overtime rule will require you to modify how you pay some of your full-time salaried employees, or you could end up facing expensive and time-consuming investigations into your labor compliance. To ensure your practice is ready for compliance with the upcoming overtime rule, check out three facts about the law. 1. The […]
Sunshine act

Are You Subject to Sunshine Act Reporting Rules? 4 Ways to Tell

Under the Sunshine Act, vendors must post the names of every provider they have a financial relationship with — and this means even accepting lunch from a drug rep will land your name on the Open Payments list. If you find out your name is listed inaccurately, you can dispute it. The problem is that […]
fincen

Include These Details in Your FinCEN Reports to Avoid Big Fines

Whether you’re familiar with the Corporate Transparency Act or not, your practice may be required to comply with the new Financial Crimes Enforcement Network (FinCEN) reporting regulations, which went into effect on January 1, 2024. If your practice is required to report and doesn’t, you could face daily penalties of $500 — a fee that […]
Medical records request

How Many Records Can Auditors Request? You May Be Surprised

It happens almost every day: Practices already stretched thin with their existing responsibilities are asked to send hundreds of medical records to auditors for “review.” The additional work and stress from the medical records request pushes practices to their limits and seems excessive to most practice managers. What recourse do you have for these voluminous […]
Physician contracts

4 Tips for New Stark Provisions Affecting Physician Contracts

It’s more important than ever to create your physician contracts to the letter of the law. A brand-new OIG ruling released in November could muddy the waters if you aren’t on top of the rules, and penalties could be huge if you are in violation of the Stark and anti-kickback laws. Check out a few […]
Compliance program

Does Your Compliance Program Meet the New OIG Guidelines?

When the OIG released its updated healthcare compliance program guidelines in November, it became clear that if you don’t have a well-designed program, you could be in violation of the regulations. Your best bet is to familiarize yourself with every detail of the new compliance program guidance so you enter 2024 with your i’s dotted […]
Medicare coding errors

Check the Biggest Medicare Coding Errors of 2023: E/M & More

Every coder knows that although most providers perform evaluation and management (E/​M) services nearly every day, coding these visits aren’t necessarily straightforward. That fact is backed up by data in the latest CMS report, which notes that established patient E/​M codes 99211-99215 were riddled with errors, most of which were due to upcoding. The facts: CMS published […]
Healthcare fraud

3 Office Managers Recently Accused of Healthcare Fraud

Time and time again, the government has proven that no one is immune from accusations of healthcare fraud. Certainly not providers, but also coders, billers and office managers. Check out three cases of office managers who were accused of healthcare fraud, what the allegations were and how you can avoid similar issues. 1. MO Office […]
Medicare claims

7.3% Medicare Error Rate Puts Documentation Issues in Spotlight

It can be unbelievably confusing to fill out your Medicare claims without making mistakes. But while errors are just a part of life in every other area, Medicare errors can be a different story. Auditors and reviewers are just waiting for you to put one wrong detail on your claims, allowing them to deny your […]
OIG work plan

HHS Adds 3 Key Issues to Latest OIG Work Plan Document

Every practice knows that the Department of Health and Human Services (HHS) assigns its watchdog agency, the OIG, to review problematic issues at medical offices, and to investigate when warranted. Investigations may end up resulting in fines and penalties for practices, which is why it’s important to avoid these reviews if at all possible. One […]