Compliance Update

Biden Administration Signals It’s in No Rush to Allow Canadian Drug Imports

The Biden administration said Friday it has no timeline on whether it will allow states to import drugs from Canada, an effort that was approved under President Donald Trump as a key strategy to control costs. Six states have passed laws to start such programs, and Florida, Colorado and New Mexico are the furthest along in plans to get federal approval. The Biden administration said states still...

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COVID Home Health Care Trend Here to Stay

With governments locking down communities to combat the COVID-19 pandemic, health care providers and practitioners scrambled to find ways to deliver care to patients at their homes or residences. CMS relaxed restrictions on providing health care via telehealth, allowing for all Medicare patients to receive care via two-way, audio and video communications, and even via telephone calls...

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Permissible Payments For Referrals Under The Federal Anti Kickback Statute

The term “payment for referral” strikes fear in the hearts of health care providers throughout the country because of the significant prohibitions under the federal Anti-Kickback Statute (AKS). And, Florida’s Patient Brokering Act (PBA) casts an even bigger shadow over arrangements involving payment in exchange for referrals. There are other statutory restrictions as well, which may apply...

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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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