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 ...
Be Prepared for a CMS Audit
The Centers for Medicare & Medicaid Services (CMS) has spent more than $1 trillion on health care programs so far this year. That sets the record for money spent by ...
What is the Stark Law?
The Stark Law, Section 1877 of the Social Security Act, places limitations on certain physician referrals. Physicians are prohibited from referring Medicare patients to health care entities — designated health ...