Compliance Update

A Quick Refresher on Medicare’s Requirements for Self-Reporting and Returning Overpayments

Many providers looked to alternative methods of treating patients and achieving outcomes this past year due to the pandemic. To meet the needs of their patients and their financial obligations, many providers implemented services that were not customary to their practice, or their billing departments. As is the case for any office that begins to provide something new, there is always the...

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CMS Releases “Telehealth for Providers: What You Need to Know”

Despite all the information about telehealth (TH) published and available since the Spring of 2020, misconceptions and misunderstandings still exist and can be costly in lost revenue and billing error recoupments. CMS has published a very comprehensive guide to TH for providers – with tons of external links for more info – and below are some handy tips and ideas. Appropriateness for TH varies...

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Eleventh Circuit Upholds Convictions for Patient Recruiter in Home Health Kickback Conspiracy

The Eleventh Circuit Court of Appeals recently upheld convictions for a South Florida patient recruiter for conspiring to defraud the United States and receiving illegal kickbacks for referring patients to a Medicare provider. The case involved Yamilet Diaz who was accused of sending Medicare beneficiaries to a home health agency in exchange for $2,000 per patient. It was alleged that between...

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FMV (Fair Market Valuation) Heads Up

FMVs are at the heart of healthcare regulatory compliance when money or anything of value changes hands in a healthcare business setting. Why? Two reasons: Healthcare laws (Stark, the Anti Kickback Statute and the Patient Brokering Act) all target money changing hands in the healthcare business space; and There are clear exemptions and exceptions that have as an essential ingredient that the...

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Settling FCA Claim From the Great Beyond

Just because you die, it doesn’t mean you can’t be held accountable for illegal activity conducted while you were still alive, as evidenced by a recent settlement agreement announced by the U.S. Department of Justice. The U.S. Attorney for the Middle District of Orlando, in late January, announced that the estate of Dr. Patrick T. Hunter paid $1.7 million to resolve allegations that he violated...

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How Autonomous Practice Is the Biggest Business Opportunity for 2021

With the passage of autonomous practice ability for nurse practitioners in Florida this year, many are wondering how this will affect the healthcare industry in Florida. In a traditional sense, rural and underserved areas should have the opportunity for growth in healthcare providers. The autonomous practice law removes restrictions on certain nurse practitioners, granting them the ability to...

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