Tag Archives: providers

Beware of Excluded Individuals and Entities

By: Anne Novick Branan One of the recent enforcement trends landing practitioners in hot water is the federal government’s pursuit of those who employ Medicare or Medicaid excluded individuals or entities. Federal statutes allow the Office of Inspector General for … Continue reading

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CMS Announces New Flexibility with MACRA

By: Mike Segal It is now quite clear that the Medicare Access and CHIP Reauthorization Act, or MACRA, enacted into law in 2015, will have a telling effect on how Medicare reimburses for physician services. In April 2016, the Centers … Continue reading

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Reminder to Health Care Providers: You Have to Disclose to Patients That You Are an Investor in the Entity To Which You Are Referring Them

By: Fred Segal Attorneys may sometimes discover that, unknown to the client, their clients may be engaging in conduct that is violative of the law. Much of the time, the client simply isn’t aware that such law exists. One of … Continue reading

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July 2016 Health Law Update Now Available

Please visit this page for the July 2016 installment of Broad and Cassel’s “Health Law Update.” Topics include Medication Therapy Management, balance billing legislation, false claims and healthcare providers and bankruptcy. If you would like to receive the “Health Law Update” … Continue reading

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Advising Buyers of Substance Abuse Businesses: Beware!

By: Heather Miller Whether you work in healthcare or are a patient in the community at large, almost everyone who has received medical care has heard of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), one of the … Continue reading

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Going on the Offensive with Combatting Fraud

By: Benton Curtis So often today we read press clippings from across the country on how the Department of Justice continues to crack down on health care fraud, be it in the criminal or civil arena. But this barrage of … Continue reading

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6 ways health care providers can reduce fraud, waste and abuse risks in 2016

By: Michael Bittman Health care providers such as hospitals and doctors face a variety of legal risks: malpractice, tax, and fraud, waste and abuse. Recent cases have shown that fraud, waste and abuse exposure can dwarf the risk of malpractice … Continue reading

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CMS Steps Up Medicare Revocation Actions

By: Anne Branan The Centers for Medicare and Medicaid Services (“CMS”) published a final rule, effective February 3, 2015, that drastically expanded CMS’s ability to revoke a provider’s Medicare billing privileges (“Final Rule”). This Final Rule has proved to be … Continue reading

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First Court Opinion Interpreting ACA’s 60-Day Rule

In rejecting a hospital system’s argument that the 60-day clock under the ACA to return a known overpayment does not commence until one is precisely identified, a New York District Court ruled this week that identification, and thus the starting … Continue reading

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Bankruptcy Ruling Limits Ability of Payers to Terminate Provider Agreements

By: Nicolette Vilmos The current economic conditions, the challenges to financing, and changes to health care coverage have led to an increase in healthcare related bankruptcy filings.  This is a trend that is likely to continue over the next few … Continue reading

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