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These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

As an example, under Section 1135 waivers, CMS has temporarily waived requirements that out-of-state telehealth practitioners must be licensed in the state where the patient is located when furnishing services in a state where the emergency is occurring. State government executive orders. Agency enforcement discretion. Federal rules.

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Medicaid Providers Beware: Failure to Appeal Audit Results or Pay Medicaid Overpayments May Result in Termination of License

The Health Law Firm

Our firm has been consulted recently by owners of different health care entities, including assisted living facilities (ALFs), group homes, home health agencies and even medical groups that had received Medicaid overpayment demands. This resulted in a Medicaid overpayment assessment.


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Avoiding Red Flags: Finding the Right Productivity Balance

Healthcare IT Today

Licensed assistants in all 50 states can see patients—with varying degrees of supervision determined by state. The payer could also recoup the overpayments from future visits. . If overbilling happens with a commercial biller, the clinic could get a letter sent to the licensing board and be put on probation.

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Treatment Center Plead Guilty to Anti-kickback Statute Violations Involving Alcohol and Drug Addiction Treatment Centers

Health Law Blog

The two individuals owned a licensed substance abuse service provider (or treatment center) offering clinical treatment services for persons suffering from alcohol and drug addiction. Continuing to employ the medical director after the doctor’s license was suspended.

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New York State to Fund Bonuses for Certain Healthcare Workers as Part of State Budget

Health Care Law Brief

Inappropriately paid claims shall constitute overpayments as defined in the Medicaid regulations and may be recovered accordingly from the employer without recoupment from, or penalty to, any covered worker.

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Compliance is Everybody’s Business: Clinical, Revenue Cycle, IT, Sales and Marketing


I’ve seen a very broad spectrum of relationships with physicians and licensed independent practitioners (LIPs) over the past 20 years. Here, any overpayment from a governmental payer source must be returned within 60 days of its identification. Physicians. I bet you have too.

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Introduction to Telebehavioral Health


Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. This compact does not apply to nurse practitioners (NPs) because they are licensed under state boards of nursing and not medicine.