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Documentation Audits Enforcement Actions

Hendershot Cowart P.C.

Qlarant, Novitas Audits Escalate as Medicare Skin Substitutes Spending Hits $1.6 Billion, CMS Seeks Evidence of Clinical...

Hendershot Cowart P.C. on

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

Ropes & Gray LLP

AI and Tech under the One Big Beautiful Bill Act: Key Restrictions, Risks, and Opportunities

Ropes & Gray LLP on

On July 4, 2025, President Trump signed “The One Big Beautiful Bill Act” into law. While much attention has focused on the bill’s rejection of a proposed 10-year federal ban on state and local artificial intelligence (“AI”)...more

Foley & Lardner LLP

The New Enforcement Landscape Under the Trump Administration’s Executive Orders

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President Trump’s executive orders, signed on January 20, 2025, have significantly altered the immigration enforcement landscape...more

Ankura

Is Internal Audit Falling Short?

Ankura on

Against the backdrop of the recent “Dear CEO” letter issued by the Financial Conduct Authority (FCA), and the number of regulatory enforcement actions, this article aims to explore the role of Internal Audit (IA) in ensuring...more

Jackson Walker

SEC Adopts Sweeping New Private Fund Adviser Rules

Jackson Walker on

On August 23, 2023, the U.S. Securities and Exchange Commission (“SEC”), by a party-line vote of 3-2, adopted new rules applicable to investment advisers to private funds (“Private Fund Advisers”) that address transparency,...more

Health Care Compliance Association (HCCA)

Physician coding and billing risks

CT magazine (August 2022) - Medical school curriculum is heavy in anatomy, physiology, biochemistry, pathology, and clinical rotations or clerkships. There is very little, if any, instruction on proper coding and billing...more

Wiley Rein LLP

[Webinar] Adjusting the Risk for Medicare Advantage: Recent Enforcement Trends and Litigation Involving Medicare Advantage Risk...

Wiley Rein LLP on

The Department of Justice (DOJ) continues to concentrate on risk adjustment programs of payers with Medicare Advantage Organizations (MAO) as a prime enforcement target. One particular area of focus, both civilly and...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Regional Healthcare Compliance Conference - Portland, OR - February 5th, 8:25 am - 5:30 pm PST

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

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