HC Compliance Essentials

How to Get Physician Buy-In on Compliance Programs

Straight from the horse’s mouth: A former physician turned CO tells all. Every compliance program needs provider buy-in, which can be tough to secure. Doctors are busy, but they have concerns that you can play into – patient care, quality…

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United Settles with Physicians, Subscribers for $350M

United agrees to record-breaking settlement covering flawed out-of-network claims for last 15 years. An important case that could change how health plans use databases to determine usual, customary and reasonable (UCR) rates has been settled, and more litigation is in…

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Keep Your Practice’s DME Dealings in the Clear

Experts reveal three ways to stay compliant in this increasingly hot risk area. Last week, we addressed how the feds will likely be increasing their scrutiny of financial relationships between physicians and DME manufacturers. buy cialis online The people…

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AMA: Doctors Abandon Medicare System Out of Frustration

A bad case of SGR-fatigue plagues many practices. With low reimbursement rates, exceptionally taxing amount of paperwork, and sky-high potential penalties, more physicians are choosing to bail out of the Medicare system. Beneficiaries already have trouble finding doctors, according to…

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New Health Care Reform Law Alters Stark “In-Office” Exception

The new health care reform laws are on the books, and physicians should be aware that some of the exceptions to the Stark law have changed. One change concerns how to qualify for the “in-office exception,” which is addressed by…

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OIG’s New ‘Compendium’ Reveals Possible Part A& B Audit Targets

The OIG has combined the old red book and orange book to come up with a “Compendium of Unimplemented Recommendations,” the latest of which was published earlier this month. The document notes outstanding recommendations to save money in Medicare…

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Avoid ‘Patient Abandonment’ by Terminating Patient Relationships Carefully

4 tips keep the trial attorneys, medical boards at bay. We recently addressed the question of what to do when a patient’s behavior endangers the rights of a health provider’s employees, specifically focusing on a…

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FERA Expands Overpayment Liability with ‘Reverse False Claims’

Plus, why it’s easier than ever for folks to become whistleblowers. If you don’t know what a reverse false claim is, it’s time to figure it out. With the Fraud Enforcement and Recovery…

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