Feds Crack Down on Inflated Admissions, Tests
When the business news pages start talking about medicine, you are probably not going to hear about the latest breakthroughs in treatments or research. These days, what you most likely ...
Ruling Gives Providers Standing Under ERISA
You may describe yourself as a doctor, a chiropractor, a surgeon or any other title conferred by your profession — but if you provide services to participants in a private ...
What to Expect at an Administrative Hearing
Health care providers are accustomed to helping those in need, but when they receive a complaint letter from the New Jersey State Board of Medical Examiners, they become the ones ...
Compliance Trouble Spots for Health Care Providers
The major regulatory changes scheduled to take effect during the next few years will create increased compliance challenges for health care providers. As such, it’s more important than ever that ...
Reimbursement and the Affordable Care Act
For years, getting paid by Medicare and Medicaid wasn’t very complicated. After health care providers performed a service, they billed for it and got paid. But now that “fee for ...
Avoiding Health Care Compliance Violations
Health care providers face a heavy burden in staying current on the countless federal laws and regulations with which they must comply. For business entities, this burden can be especially ...
Affordable Care Act Makes Important Changes to the Stark Law
The Stark Law is a federal health care statute that limits physician referrals. The Affordable Care Act (ACA) has made some important changes to the Stark Law that medical providers ...
HIPAA Privacy Rules for Covered Entities and Business Associates
The Health Insurance Portability and Accountability Act (HIPAA) is intended to protect the privacy of patients’ health information. But navigating HIPAA can be confusing because it is often difficult to ...
Reimbursement Delays and Doctors’ Bottom Lines
Doctors can struggle to pay bills too. A few years ago, California switched Medicaid payment contractors, and the botched handoff resulted in months-long delays in payments to health care providers. ...
The Affordable Care Act’s War on Fraud
In April 2012, Kathleen Sebelius was in a triumphant mood. “We have a simple message to criminals thinking about committing Medicare fraud: don’t even try,” the Health and Human Services ...