» Texas Doctor Charged in PT Fraud Cases

Texas Doctor Charged in PT Fraud Cases

Monday, April 19, 2010

Aside from illegal drug distribution, feds link her to a $30M physical therapy scam. You might be too young to get benefits, but you’re never too old to commit Medicare fraud: That’s the latest message in the constant string of…

How the PPACA Affects Your Practice Now

Monday, April 12, 2010

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Last month, the president signed the Patient Protection and Affordable Care Act (PPACA) into law to much fanfare. Although most of the law’s 2,390 pages were not specifically related to Medicare, some of the bill does pertain to Part B. Read on to…

Do My Physician’s SNF Claims Violate Stark Laws?

Monday, February 1, 2010

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What’s the road to compliance when a SNF’s medical director also bills fee-for-service? Question: My physician is the medical director for a skilled nursing facility and receives a stipend from the SNF for that service. Can he still bill for…

Physician Compliance: OIG Will Stay ‘Aggressive’

Monday, December 14, 2009

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Why the OIG is looking to sock it to ophthalmology services, chiropractic, ultrasound & other Medicare procedures. If you’ve ever wondered whether the OIG collects on its audits, the agency’s new report answers that question to the tune of $20.97…

Incentivize Docs to Adopt EHR — & Still Comply with Stark

Monday, November 23, 2009

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One hospital system is taking the plunge on EHR standardization and spending millions to incentivize its physicians to adopt the program — and officials there remembered to check Stark law. The North Shore-LIJ Health System announced in…

COMPLIANCE TRENDS: Covenant Case Holds Stark Reminders for Hospitals, Physicians

Monday, November 2, 2009

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Don’t rely overly on the employment exception — or discount a competitor’s ability to stir up trouble. Covenant Medical Center in Waterloo, Iowa, recently agreed to fork over a hefty $4.5 million to settle a federal False Claims Act lawsuit involving alleged…

Physician Billing Compliance Question: Co-Pays

Sunday, November 1, 2009

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Question: We are having an issue in our office regarding 56441. The patient had a vaginal adhesion which was corrected simply in the doctor’s office. The problem is that the patient is getting charged a higher copay because of the…

OIG Dragnets of IDTFs and EMTALA Pressure Physicians

Monday, October 26, 2009

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The OIG’s 2010 Work Plan is full of clear enforcement and compliance goals that will affect physicians. And then there are other issues the OIG will investigate that at first may not seem to have much to…

FERA Expands FCA Liability to Subcontractors

Monday, October 26, 2009

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Find out why the feds are looking even harder at HHA & hospice therapy services. As if worrying about compliance with the False Claims Act wasn’t enough: As part of the follow-on to the 2009 stimulus package,…

OIG to Review Place-of-Service Errors and Provider-Based Status

Monday, October 19, 2009

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Where physicians perform procedures can make all the difference — in both their reimbursement levels and in how interested the government is in their business. In its 2010 Work Plan, the OIG says it…

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