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Compliance

Compliance

DME and Stark Law

5 Ways Medical Practices Can Spot Risky DME Arrangements

As many medical practices are aware, Durable Medical Equipment (DME) fraud is running rampant, and you could be pulled into a case even if you didn’t knowingly violate the Stark law or Anti-Kickback Statute. Why? Because a DME supplier who violates these laws could present your provider’s DME prescriptions as evidence to shift liability away from […]
Published Date: September 26, 2022
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Healthcare audit

Key Strategies Help You Avoid a Medicaid Audit

As part of the Centers for Medicare & Medicaid Services (CMS), Medicaid auditors are eager to come after potential instances of fraud or abuse that could cost you a fortune in fines, penalties and exclusions if you aren’t careful. Check out several areas that Medicaid auditors are targeting, and find out how you can stay […]
Published Date: September 13, 2022
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HIPAA risk analysis

Create a Solid Telehealth HIPAA Risk Analysis Checklist

Your practice has created a Notice of Privacy Practices, overhauled your policies, and ensured that you don’t have any privacy breaches. But if you haven’t yet performed a HIPAA risk analysis, you’re falling short of the security rules. And with telehealth in such wide use, now is the time to make sure your patient information […]
Published Date: August 25, 2022
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fees for copies of medical records

Accurately Calculate Patient Record Copying Fees to Avoid Fines

Every practice manager knows how important it is to provide patients with access to their medical records as required by the HIPAA laws. But what you may be less clear about is how to calculate fees for copies of medical records — and if you ask patients to pay too much, you could be hit […]
Published Date: August 1, 2022
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DOL investigator

Hire Attorney Early & Protect Against DOL Investigator Overreach

Although being investigated by the Department of Labor (DOL) may not be something you worry about every day, it is a very real possibility. DOL investigations have skyrocketed since COVID, along with penalties when compliance violations are uncovered. And if a DOL investigator shows up at your door, it can easily send you into panic […]
Published Date: June 16, 2022
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Medicare excluded individuals

OIG Exclusion List: Avoid Losing Your Medicare Billing Rights

As a practice that accepts Medicare and Medicaid, you are required to know the exemption status of your candidates, employees, and vendors. Failure to do so can have dire consequences, such as significant fines, loss of your ability to bill Medicare and Medicaid, and even jail time (in extreme cases). Even an innocent mistake can […]
Published Date: March 24, 2022
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Information blocking rule

Avoid Information Blocking Violations for Patient Records Access

Federal law requires that you provide your patients with “adequate access” to their medical records based on a specific set of criteria. Fail to comply, and you could be hit with significant violation penalties. Information blocking rule. The problem is that these rules are confusing and implementing them correctly can be a challenge  This post […]
Published Date: December 3, 2021
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1135-based licensure waivers

Get Ready: 1135 Waivers, Licensing Extensions Ending Soon

HHS recently extended the Public Health Emergency (PHE) into January 2021, keeping the 1135 waivers — including licensing requirements — in place, for now. While there is no definitive expiration date for the waivers, one thing is certain — these waivers will end, and if you’re not prepared you could lose your license. 1135 Waivers […]
Published Date: November 16, 2020
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Medicare ABN Mandatory

Is an ABN Mandatory or Voluntary? Here are 4 Clues to Decide

The Medicare Advance Beneficiary Notice (ABN) form is only one page long, but accurately completing the process can be as tedious as waiting for the repair man to show up. And it’s really critical that you take the time to get each step right, or you’ll be faced with increased write-offs and could even land […]
Published Date: August 12, 2020
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Compliance program new rules

DOJ New Rules: Fund Your Compliance Plan or Face Massive Fines

With so many improvement areas competing for resources, a sufficiently financed and living breathing compliance plan has not been high on your priority list. But new guidance released June 1 from the Department of Justice (DOJ) that determines penalties based on these added requirements means you must update your compliance program now to avoid massive […]
Published Date: June 16, 2020
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