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Physicians › Billing › Healthcare Fraud

Hendershot Cowart P.C.

Legal Remedies for Physicians When Medical Billing Companies Fail to Perform

Hendershot Cowart P.C. on

For physicians with independent practices, engaging a third-party billing company to manage the billing process is an attractive option. Medical billing is increasingly complex and time consuming, and outsourcing that...more

ArentFox Schiff

Dispute Not Resolved: BCBSGA Sues Providers for Alleged Misuse of NSA Arbitration Process

ArentFox Schiff on

On May 27, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGA) filed a lawsuit in the Northern District of Georgia US District Court, alleging that a group of health care providers, along with their third-party...more

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

J.S. Held on

In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more

Health Care Compliance Association (HCCA)

[Event] Research Compliance Conference - June 2nd - 4th, Orlando, FL

Health Care Compliance Association (HCCA) on

Get the latest insights in research compliance - The risks and challenges that come with clinical research are unique, as are the abundance of government regulations and enforcers that oversee them. HCCA’s Research...more

Husch Blackwell LLP

Physician Loses Rare Criminal E/M Fraud Trial

Husch Blackwell LLP on

Evaluation and management (E/M) services have been called “the core” of healthcare billing. E/M is a catch-all claim, allowing medical professionals to bill for diagnosing or treating nearly any illness or injury. E/M is also...more

Health Care Compliance Association (HCCA)

[Virtual Event] Behavioral health compliance through deterrence - March 9th, 12:00 pm - 1:30 pm CT

Health Care Compliance Association (HCCA) on

Learning objectives: - If presented with the opportunity to open a behavioral health company and the offer sounds too good to be true, it most likely is. - Do not sign documents if they are blank or you are being...more

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: Avoiding the Pitfalls in Recent Government Enforcement - December 8th, 12:00 pm - 1:00 pm ET

Rivkin Radler LLP on

Please join us for the December Lunch and Learn with Benjamin Malerba and Benjamin Wisher. The pair will discuss recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG and...more

Bass, Berry & Sims PLC

[Virtual Conference] Nashville Healthcare Fraud Conference - December 15th - 16th, 8:00 am - 1:00 pm CST

Bass, Berry & Sims PLC on

Please join us for the 8th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more

Oberheiden P.C.

Medicare TPE Audits: 7 Common Questions Answered

Oberheiden P.C. on

The Centers for Medicare and Medicaid Services (CMS) and its audit contractors have recently increased their use of Targeted Probe and Educate (TPE) audits to target providers suspected of improperly billing Medicare. While...more

Oberheiden P.C.

Federal Government Targets Providers Administering Amniotic Injections

Oberheiden P.C. on

The federal government has recently made clear its intention to go after healthcare providers who provide amniotic injections to certain Medicare and Medicaid recipients. Over recent years, the federal government has...more

Akin Gump Strauss Hauer & Feld LLP

11th Circuit’s Decision in AseraCare: Important in Determining When Clinical Judgment Regarding Medical Necessity Can Result in an...

Akin Gump Strauss Hauer & Feld LLP on

• Reasonable disagreement among clinicians, by itself, does not result in a false claim. • Clinical judgment must be objectively false to constitute an FCA violation. • A clinical judgment may only be objectively false...more

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