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Billing Medicare or Medicaid? Understanding Your Audit Risk

If you are a healthcare provider enrolled with Medicare and Medicaid, it is imperative that you know the governmental agencies’ expectations for compliant billing and understand that the agencies constantly monitor and audit...more

CMS Revocation and Preclusion: The “Secret” Exclusion

On April 1, 2019, the Center for Medicare and Medicaid Services (“CMS”) announced a new exclusion sanction: the CMS Preclusion List. This lesser-known sanction is different than placement on the Office of Inspector General...more

SMRC Targets for 2022: After Heavy Focus on Hospice, the SMRC Moves On to Home Health and Other Projects

The Supplemental Medical Review Contractor (“SMRC”) is a Centers for Medicare and Medicaid Services (“CMS”) contractor authorized to conduct nationwide medical reviews (Medicare Part A, Part B, and DME). As many in the...more

Rapid Rise in Telehealth Leads to Significant Oversight: How to Prepare Now for New Audit Activities

The Pandemic led to a rise in the use of telehealth and a recognition of its value. When the COVID-19 pandemic began, the use of telehealth to provide healthcare services and enhance access to health care grew at an...more

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