The wound care industry faces unprecedented scrutiny as Medicare Part B expenditures for skin substitutes exceeded $1.6 billion in the fourth quarter of 2023 alone. The spending surge has triggered a wave of skin substitute...more
7/18/2025
/ Audits ,
Best Practices ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Documentation ,
Enforcement Actions ,
Fraud ,
Health Care Providers ,
Health Insurance ,
Healthcare Fraud ,
Medical Devices ,
Medical Records ,
Medicare ,
Medicare Part B ,
Popular ,
Regulatory Requirements ,
Reporting Requirements
Healthcare fraud enforcement continues to be a top priority for federal authorities, with Stark Law violations remaining under particular scrutiny. The complex nature of physician self-referral regulations, combined with...more
1/23/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Medicare ,
OIG ,
Patient Referrals ,
Self-Disclosure Requirements ,
Stark Law ,
Texas ,
TRICARE
Prescription drug fraud has long been a focus for government regulators, but it has taken on new significance in the wake of America’s opioid crisis. The U.S. Department of Justice (DOJ), Department of Health and Human...more
3/22/2024
/ Anti-Kickback Statute ,
Civil Investigation Demand ,
DEA ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
FBI ,
Fraud ,
Healthcare ,
Medicaid ,
Medicare ,
Medicare Administrative Contractors (MAC) ,
Opioid ,
Pharmaceutical Industry ,
Pharmacies ,
Popular ,
Prescription Drugs ,
Telemedicine ,
TRICARE
Telemedicine companies are supposed to facilitate medically necessary services to beneficiaries over the telephone via licensed medical professionals. In reality, however, many of these “telemedicine companies” are...more
3/11/2024
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Medicaid ,
Medical Testing ,
Medicare ,
OIG ,
Physicians ,
Prescription Drugs ,
Telemedicine ,
TRICARE
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a report last month assessing the program integrity risks associated with Medicare telehealth services. After analyzing...more