The Health Law Firm Blog

JULY 13, 2023

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.]

Licensing 52

Licensing Medicaid Medicaid Fraud 52

The Health Law Firm Blog

JULY 11, 2022

Board Certified by The Florida Bar in Health Law Do you have a medical, pharmacist, counselor, or nursing license in more than one state? Do you have a license in more than one profession? By George F. Indest III, J.D., Have you been notified that an investigation has been opened against your professional [.].

Licensing 52

Licensing Nurses Medicaid Medicaid 52

MedTrainer

MAY 10, 2024

It can also be a prerequisite for enrolling with an insurance network or Medicare for the first time. Here’s what a typical credentialer’s workflow looks like: Like other providers, mental health professionals must be licensed in states where they offer services and enrolled with payers doing business in those areas. Effective Jan.

Licensing 52

Licensing ACA Medicare Medicare 52

MedTrainer

MAY 7, 2024

This blog will highlight how credentialers can navigate UnitedHealthcare provider enrollment. Built-in Automation: Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration. It’s a challenge.

Malpractice 52

Malpractice Licensing Medicaid Medicaid 52

MedTrainer

MARCH 30, 2024

Built-in Automation Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration. Choose software with dynamic graphs that show application age, average time to complete applications, and number of closed applications per credentialer.

Malpractice 98

Malpractice Licensing Medicaid Medicaid 98

The Health Law Firm Blog

JULY 26, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayments 52

The Health Law Firm Blog

JUNE 27, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayments 52

The Health Law Firm Blog

JUNE 9, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayments 52

Hall Render

DECEMBER 30, 2022

Medicare payment policy changes established under the CMS CY 2023 Medicare Physician Fee Schedule (“MPFS”) Final Rule , issued on November 1, 2022, become effective January 1, 2023. These services will be reported with three separate Medicare-specific G codes. Evaluation and Management (E/M) Visits. Split/Shared E/M Visits.

Medicare 40

Medicare Medicare Licensing Health Services Administration 40

The Health Law Firm Blog

MAY 17, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayments 52

Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

Medicare 52

Medicare Medicare Licensing Health Insurance 52

The Health Law Firm Blog

NOVEMBER 18, 2023

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.]

Medicare 40

Medicare Medicare Hospitals Governance 40

The Health Law Firm Blog

JANUARY 9, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.]

Licensing 52

Licensing Doctors Nurses Medicare 52

The Health Law Firm Blog

APRIL 18, 2022

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.].

Licensing 40

Licensing Medicaid Medicaid Fraud 40

MedTrainer

APRIL 11, 2024

This blog will discuss potential healthcare credentialing challenges, strategies to prevent these problems, and how credentialing software makes the process efficient and effective. Noncompliance: Providers must maintain specific licenses and certifications to provide patient care services. What Is Healthcare Credentialing?

Licensing 52

Licensing Medicaid Medicaid Medicare 52

Health Law Advisor

SEPTEMBER 1, 2023

On August 29, 2023, the Centers for Medicare & Medicaid Services (CMS) announced the ten (10) Medicare Part D drugs selected for the first round of negotiations of the Medicare Drug Price Negotiation Program (Program)—a few days before the September 1, 2023, statutory deadline imposed by the Inflation Reduction Act (IRA).

Medicare 69

Medicare Medicare Licensing Medicaid 69

The Health Law Firm Blog

AUGUST 23, 2022

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.].

Medicare 52

Medicare Medicare Hospitals Governance 52

The Health Law Firm Blog

JANUARY 8, 2024

Previously published on October 14, 2022By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you [.]

Licensing 52

Licensing Doctors Nurses Medicare 52

MedTrainer

MAY 6, 2024

This blog will highlight how credentialers can navigate Aetna provider enrollment. Built-in Automation: Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration.

Licensing 52

Licensing Malpractice Health Insurance Medicaid 52

Verisys

MAY 13, 2024

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. April 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Secure your success by choosing Verisys.

Fraud 52

Fraud COVID-19 Doctors Licensing 52

Pharmacy Law Blog

MAY 14, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

Licensing 40

Licensing Nurses Medicaid Medicaid 40

Pharmacy Law Blog

MAY 7, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

Licensing 40

Licensing Nurses Medicaid Medicaid 40

The Health Law Firm Blog

DECEMBER 3, 2023

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.]

Licensing 40

Licensing Governance Health Care Lawyers Medicaid 40

MedTrainer

FEBRUARY 12, 2024

In this blog, we’ll outline why reporting healthcare non-compliance is non-negotiable and how software platforms make it easier to stay in compliance with the myriad regulations that govern good healthcare. Non-compliance can lead to significant fines, legal battles, and the loss of license or accreditation.

Compliance 52

Compliance Licensing Governance Fraud 52

Verisys

MARCH 8, 2024

Million Medicare and Medicaid Fraud Full Story Pharmacist Fraud Pharmacy Owner and Operations Manager Convicted of $2.3M With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Secure your success by choosing Verisys.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

The Health Law Firm Blog

JANUARY 26, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.]

Licensing 40

Licensing Doctors Nurses Medicare 40

Verisys

NOVEMBER 8, 2023

The NPI improves the Medicare and Medicaid programs, other federal and private health programs, and the overall effectiveness and efficiency of the healthcare industry by simplifying administration and enabling the efficient electronic transmission of health information. Providers also need an NPI to enroll in Medicare.

Fraud 97

Fraud HIPAA Medicare Medicare 97

The Health Law Firm Blog

OCTOBER 15, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.].

Licensing 52

Licensing Doctors Nurses Medicare 52

The Health Law Firm Blog

OCTOBER 14, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.].

Licensing 52

Licensing Doctors Nurses Medicare 52

MedTrainer

FEBRUARY 5, 2024

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. The information confirms a provider is currently licensed to practice medicine.

Licensing 52

Licensing Governance Compliance Fraud 52

The Health Law Firm Blog

SEPTEMBER 8, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.].

Licensing 52

Licensing Governance Health Care Lawyers Medicaid 52

MedTrainer

FEBRUARY 20, 2024

In this blog, we’ll review what is insurance credentialing, the process, and who’s required to complete insurance credentialing. While these professions do require credentialing, many other licensed healthcare providers require insurance credentialing as well. There are many steps to this time-consuming process.

Licensing 52

Licensing Medical Billing Compliance Medicaid 52

The Health Law Firm Blog

APRIL 1, 2024

Board Certified by The Florida Bar in Health Law We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports. By George F. Indest III, J.D.,

Licensing 52

Licensing Nurses Medicare Medicare 52

The Health Law Firm Blog

SEPTEMBER 8, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.].

Licensing 52

Licensing Governance Health Care Lawyers Medicaid 52

Verisys

NOVEMBER 3, 2023

Agrees to Pay $653,143 to Resolve Allegations of Kickback Violations Full Story Physician Fraud Georgia doctor ordered to pay $27 million for submitting false claims to Medicare Full Story Louisiana Doctor Pleads Guilty in $5,600,000 Medicare Fraud Scheme Full Story Florida Pain Management Physician Agrees To Pay $1.5

Fraud 52

Fraud Compliance Medicare Medicare 52

Verisys

FEBRUARY 9, 2024

Million Full Story Doctor Agrees to Pay $95,000 to Settle Allegations of Health Care Fraud Full Story Columbia Physician Indicted for False Statements to Medicare Full Story Pharmacist Fraud Current and Former Owners of Center City Philadelphia Pharmacy Agree to Pay Over $4.6 Secure your success by choosing Verisys.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Healthcare Law Blog

FEBRUARY 28, 2023

On February 13, 2023, the Centers for Medicare and Medicaid Services (CMS) published the revised List of Telehealth Services for Calendar Year (CY) 2023 (List). The List includes the services that are payable under the Medicare Physician Fee Schedule when furnished via telehealth.

Medicare 52

Medicare Medicare Nurses Licensing 52