In Billing
Sep 10th, 2018
A proposed change to signature requirements in 2019 may effect your practice. The Physician Self-referral Law, or Stark Law,  prohibits physicians to refer Medicare patients for certain designated health services (DHS) to an entity with which the physician (or a member of the physician’s immediate family) has a financial relationship. The DHS entity is held to the ...
Promote a compliant environment within your organization, before the whistle is blown. The most notable Medicare fraud cases in the last five years have been whistleblower cases in which someone with inside knowledge of a health system or physician practice (usually an employed physician or administrator) files suit against the employer under the federal False ...
Jan 26th, 2016
Two recent cases from Georgia demonstrate that organizations must not ignore—and certainly shouldn’t fire (as a knee-jerk reaction)—employees who raise compliance concerns and who are protected by the False Claims Act (FCA). In one case, HCA Holdings, Inc., (HCA) the largest operator of healthcare facilities in the United States, entered into an agreement with the ...
Nov 5th, 2015
Vulnerabilities in your healthcare organization are expensive. Compliance is a cost of doing business, and must be a priority for all healthcare organizations. As you enact your compliance program, keep in mind: A culture of compliance starts at the top. Treating compliance as a partnership, instead of a police action, will help to obtain buy-in ...
Jun 11th, 2015
by John Verhovshek, MA, CPC The first step to achieving healthcare compliance is: Have a plan. Policies, standards, and procedures prevent ambiguity and indecision, and demonstrate a good faith effort to achieve compliance. When robustly communicated and observed, standards and procedures establish tighter internal controls to counter potential risks. Even absent the formality of specific ...