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. [.]

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Compliancy Group

MARCH 8, 2023

are missing out on most of these opportunities because their names are on the HHS OIG (Health and Human Services, Office of Inspector General) Medicare Exclusion List. How the OIG Exclusion Database Came to Be HHS oversees the CMS (Center for Medicare Services), which administers the Medicare program.

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Healthcare IT News - Telehealth

NOVEMBER 10, 2020

Prepare Now for Anticipated Changes to Medicare and Private Payer Rules. The Centers for Medicare and Medicaid Services (CMS) is expected to issue new rules for telehealth in the release 2021 Physician Fee Schedule later this year. Today, Medicare reimburses for specific services when delivered via live video.

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Innovaare Compliance

JANUARY 15, 2024

The Prescription Drug Program, commonly known as Medicare Part D, is undergoing significant transformations in 2025 due to the Inflation Reduction Act (IRA) of 2022. Medicare Part D will have three (3) phases instead of four (4) – Deductible, Initial Coverage Phase and Catastrophic Phase. generics) in the catastrophic phase.

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The Health Law Firm

FEBRUARY 14, 2022

million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. Additionally, the doctor indicated that he was sought to directly address CMS and the Medical Practice's ability to bill Medicare and Medicaid. Indest III, J.D., The doctor argued that the bail condition impeded his ability to practice medicine.

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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 [.].

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Bill of Health

OCTOBER 19, 2023

The traditional model for post-graduate education for medical students, called residency, is regulated by the Accreditation Council for Graduate Medical Education ( ACGME ) and largely funded by the Center for Medicare Services (CMS). There is an urgent need for Congress to ensure this funding through the Center for Medicare Services.

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Medisys Compliance

MAY 19, 2022

During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. In this article, we shared revised Medicare billing and coding guidelines which will help in billing Medicare telehealth during COVID-19 PHE.

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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.

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Medisys Compliance

FEBRUARY 7, 2022

Medicare pays a physician for an Annual Wellness Visit (AWV) service. This visit is planned to develop or update a Personalized Prevention Plan (PPP) and perform a Health Risk Assessment (HRA) which is covered once every 12 months by Medicare. Medicare also waives the AWV coinsurance or co-payment and the Medicare Part B deductible.

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Medisys Compliance

JUNE 10, 2022

Medicare covers limited chiropractic services when performed by a chiropractor who is licensed or legally authorized to furnish chiropractic services by the State or jurisdiction in which the services are furnished. In this article, we shared coding guidelines and Medicare coverage for Chiropractic Manipulative Treatment (CMT).

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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).

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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.,

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Medisys Compliance

JUNE 20, 2022

Under Fee-for-service (FFS) Medicare, home infusion therapy (HIT) involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. Medicare Coverage. In case any assistance needed for Medicare medical billing services, contact us at info@medisysdata.com/ 302-261-9187.

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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.,

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HIT Consultant

APRIL 1, 2024

Specifically, the government claims that TRG: Failed to ensure adequate review of radiology scans: TRG allegedly used contractors located outside the United States, who were not licensed to practice medicine in the US, to prepare draft interpretations of radiology scans.

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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.,

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The Health Law Firm

DECEMBER 2, 2021

Board Certified by The Florida Bar in Health Law Often a physician, dentist, nurse, or other health professional will be placed on the Medicare List of Excluded Individuals and Entities, or the LEIE. Being placed on this list in itself can have severe consequences beyond just a prohibition against billing the Medicare Program.

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Healthcare It News

FEBRUARY 2, 2023

This system allows the creation of Medicare-compliant GP management plans and team care arrangements, which can be automatically shared with the care team. NQPHN have already acquired 12-month licenses to use the system on behalf of participating GPs. Enterprise Taxonomy: Quality Care Workflow Care Process

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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

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 [.]

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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 [.]

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Licensing Doctors Nurses Medicare 52

Medisys Compliance

APRIL 11, 2024

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. This milestone represents a major victory for the mental health professions, expanding access to much-needed care for Medicare beneficiaries and offering exciting new possibilities for MFTs and MHCs.

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Medicare Medicare Medical Billing Outsourcing Medical Billing 59

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. [.].

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Licensing Medicaid Medicaid Fraud 40

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.

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Medicare Medicare Licensing Health Services Administration 40

Innovaare Compliance

OCTOBER 6, 2022

Annual Election Period (AEP) is about two weeks away when Medicare Advantage Prescription Drug Plans (MAPD) will be signing up new enrollees by the thousands. According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising. In 2022, 48% of all eligible Medicare beneficiaries are enrolled in MAPD.

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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 [.].

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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 [.]

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Licensing Doctors Nurses Medicare 52

Healthcare Law Today

NOVEMBER 9, 2022

Starting January 1, 2023, Medicare will expand and increase coverage of certain services and providers to advance access to prevention and treatment services for substance use disorders (SUD) and mental health services. The combination of the opioid crisis and the COVID-19 pandemic have led to record need for behavioral health treatment.

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Medicare Medicare COVID-19 Licensing 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.

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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 [.]

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The Health Law Firm

OCTOBER 31, 2019

According to prosecutors, the doctor allegedly authorized genetic testing for patients he never met, in a state where he’s not licensed to practice medicine. billion worth of false Medicare and Medicaid claims between July 2018 and January 2019. The vast fraud scheme totaled $2.1 This appears to be a new national record.

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Healthcare IT News - Telehealth

JUNE 8, 2022

Additionally, several telehealth flexibilities (that generally expand Medicare coverage for telehealth services) have been extended 151 days (about five months) beyond the termination of the HHS PHE. Outside the blanket waiver, it is also a CMS reimbursement requirement that the practitioner must be licensed in the state.

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The Health Law Firm

DECEMBER 23, 2019

Board Certified by The Florida Bar in Health Law Healthcare professionals: Have you ever had discipline on your professional license during your career? Have you ever been assessed a repayment or fine by Medicare or Medicaid Programs or had your participation in that program terminated or suspended? Indest III, J.D.,

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MedTrainer

APRIL 11, 2024

Noncompliance: Providers must maintain specific licenses and certifications to provide patient care services. These include a national provider identification number , state licensure, drug enforcement agency license , and state pharmacy license. Check out 10 attributes to look for in a credentialing specialist.

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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.

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Healthcare IT News - Telehealth

APRIL 10, 2020

The Centers for Medicare and Medicaid Services has temporarily suspended several regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the coronavirus pandemic.

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