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Legal

Legal

Healthcare Compliance Program

3 OIG Compliance Strategies to Protect Your Practice

For many physician practices, compliance feels like another administrative burden competing for your time. Between staffing shortages, declining reimbursement, prior authorizations, coding updates, and increasing documentation requirements, compliance often gets pushed to the bottom of the priority list. Unfortunately, that’s becoming a costly mistake. Today, the Department of Justice (DOJ) and the Office of Inspector […]
doj compliance rule

5 Ways to Protect Your Practice From DOJ Fraud Investigations

The days of assuming government healthcare fraud investigations take years are over. Federal agencies are using advanced data analytics, increased interagency collaboration, and proactive enforcement strategies to identify questionable billing patterns sooner than ever before. While most physician practices strive to bill accurately, even documentation errors, inconsistent coding, or weak compliance processes can attract unwanted […]
2021 Stark Exceptions

Key Differences Between Stark Law & Anti-Kickback Statue Explained

If you’re like most medical practices, you’ve probably heard of both Stark Law and the Anti-Kickback Statute—but the differences between them are where most compliance mistakes happen. Here’s the problem: Many practices assume that if they’re compliant with one law, they’re safe. That’s not true. In fact, the Office of Inspector General (OIG) makes it […]
I-9 documents

I-9 Compliance Just Got Stricter—Here’s What Your Practice Needs to Do Now

If you’re hiring in your medical practice—even one employee—your Form I-9 process just became a much bigger risk area. In March 2026, U.S. Immigration and Customs Enforcement updated its inspection guidance, and legal analysts are warning that many errors previously treated as minor or “technical” are now being treated as substantive violations—which means immediate fines […]
Stark Law 2020 CMS Proposed New Rule

Anti-Kickback Statute Explained to Avoid Fines, Audits, and False Claims Risk

The Anti-Kickback Statute (AKS) is one of the most aggressively enforced laws in healthcare—and one of the easiest to violate without realizing it. It applies to almost every financial interaction in your practice, especially those tied to referrals or business generation. Unlike Stark Law, AKS is a criminal statute. That means violations can result in […]
Stark Rules

How to Avoid Costly Self-Referral Violations with Stark Law Compliance

If you’re a physician or practice manager, Stark Law is one of the easiest ways to accidentally put your practice at risk. It doesn’t require intent—just the existence of a financial relationship tied to referrals can trigger a violation. That means everyday business decisions like ownership, compensation, or referral workflows can create compliance exposure without […]
RELEASE-OF-MEDICAL-RECORDS-SUBPOENA

How You Should Respond to Subpoenas for Medical Records

If you work in a medical practice, you will eventually get a subpoena or other legal request for medical records. Handling these improperly can put you at risk of HIPAA violations, state privacy law violations, costly fines, and loss of patient trust. That’s why understanding how to respond correctly to subpoenas for medical records is […]
Medicare Advantage Overpayments

Medicare Advantage Out-of-Network Coverage: How Your Medical Practice Can Prevent Claim Denials

If your medical practice treats Medicare Advantage patients, understanding out-of-network coverage rules is essential to avoid claim denials, compliance risks, and lost revenue. Many billing teams assume these plans never cover out-of-network care, but federal Medicare rules require coverage in specific situations. Knowing these requirements protects reimbursement and prevents unnecessary appeals. Federal CMS regulations require […]
balance billing compliance

Balance Billing Compliance: How Your Medical Practice Avoids Penalties, Patient Complaints & Revenue Loss

Balance billing compliance is no longer just a hospital issue — it affects physician practices, ambulatory surgery centers, imaging centers, and specialty clinics. The No Surprises Act (NSA) and Good Faith Estimate (GFE) rules require you to rethink how your front desk, billing department, and compliance team communicate costs to patients. If your workflows are […]
Florida patient refund law 2026

How to Comply with Florida’s 2026 Patient Refund Law

Florida’s Patient Refund Law takes effect January 1, 2026, and it directly affects how your practice handles patient overpayments. If you collect more than a patient owes—even unintentionally—you are now on a strict clock to identify, process, and return those funds. This law is not just about awareness. It requires clear workflows, trained staff, documented […]