The Health Law Firm Blog

JULY 11, 2022

Board Certified by The Florida Bar in Health Law Do you have a medical, pharmacist, counselor, or nursing license in more than one state? Do you have a license in more than one profession? By George F. Indest III, J.D., Have you been notified that an investigation has been opened against your professional [.].

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Licensing Nurses Medicaid Medicaid 52

MRO Compliance

JUNE 1, 2022

HEDIS (Healthcare Effectiveness and Data Information Set) is part of a review process for Medicare Advantage plan quality measures. Depending on the score of a health plan, payers may receive considerable Medicare financial incentives if a score exceeds a certain level. HEDIS audits are important for Medicare and Medicaid health plans.

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Medicare Medicare Compliance Medicaid 130

The Health Law Firm Blog

JULY 13, 2023

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.]

Licensing 52

Licensing Medicaid Medicaid Fraud 52

Innovaare Compliance

JANUARY 15, 2024

The Prescription Drug Program, commonly known as Medicare Part D, is undergoing significant transformations in 2025 due to the Inflation Reduction Act (IRA) of 2022. This blog delves into the details of these changes and their implications for plan sponsors and beneficiaries. Are you prepared for the Medicare Part D changes in 2025?

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Medicare Medicare Compliance FDA 52

Pharmacy Law Blog

MAY 7, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

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Licensing Nurses Medicaid Medicaid 40

Pharmacy Law Blog

MAY 14, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

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Licensing Nurses Medicaid Medicaid 40

Bill of Health

FEBRUARY 23, 2023

On August 19, 2022 the Centers for Medicare and Medicaid Services announced plans to require nursing facilities to vaccinate most employees to continue to receive federal reimbursements. States that sought to inhibit vaccine mandates faced alternative arguments framed in federal conditional spending powers and preemption.

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Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

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Medicare Medicare Licensing Health Insurance 52

Healthcare Law Blog

OCTOBER 21, 2022

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. It can be found here.

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Licensing Medicaid Medicaid Hospitals 97

Health Populi

JULY 26, 2022

Iora Health has focused on the Medicare-enrolled population, distinct from ONEM’s target patient market of younger, employed consumers. State pharmacy licenses with the deal. The deal was announced on 21 July, with Amazon striking the price at about $3.9 bn and MGM Studios for $8.5 bn and MGM Studios for $8.5

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Health Insurance Doctors Medicare Medicare 165

Verisys

NOVEMBER 8, 2023

The NPI improves the Medicare and Medicaid programs, other federal and private health programs, and the overall effectiveness and efficiency of the healthcare industry by simplifying administration and enabling the efficient electronic transmission of health information. Providers also need an NPI to enroll in Medicare.

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Fraud HIPAA Medicare Medicare 97

Hall Render

DECEMBER 12, 2023

On November 16, 2023, the Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare provider enrollment requirements in the Calendar Year 2024 Physician Fee Schedule final rule (“Final Rule”).

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Medicare Medicare Licensing Malpractice 40

The Health Law Firm Blog

AUGUST 23, 2022

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.].

Medicare 52

Medicare Medicare Hospitals Governance 52

The Health Law Firm Blog

JULY 26, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayment 52

The Health Law Firm Blog

JUNE 27, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayment 52

The Health Law Firm Blog

JUNE 9, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayment 52

The Health Law Firm Blog

MAY 17, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayment 52

The Health Law Firm Blog

APRIL 18, 2022

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.].

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Licensing Medicaid Medicaid Fraud 40

The Health Law Firm Blog

JANUARY 9, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.]

Licensing 52

Licensing Doctors Nurses Medicare 52

Hall Render

DECEMBER 30, 2022

Medicare payment policy changes established under the CMS CY 2023 Medicare Physician Fee Schedule (“MPFS”) Final Rule , issued on November 1, 2022, become effective January 1, 2023. These services will be reported with three separate Medicare-specific G codes. Evaluation and Management (E/M) Visits. Split/Shared E/M Visits.

Medicare 40

Medicare Medicare Licensing Health Services Administration 40

MedTrainer

JULY 28, 2023

OIG Inspections in Healthcare The OIG focuses its resources on oversight of Medicare and Medicaid — programs that represent a large portion of the federal budget. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers. Tips and Leads From Law Enforcement Agencies.

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Fraud Compliance Medicaid Medicaid 98

The Health Law Firm Blog

JANUARY 8, 2024

Previously published on October 14, 2022By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you [.]

Licensing 52

Licensing Doctors Nurses Medicare 52

Verisys

DECEMBER 29, 2024

Credentialing services perform this verification by contacting primary sources, such as medical schools and licensing boards, to confirm the physician’s education and qualifications. Without proper credentialing, physicians cannot apply for privileges, bill for services, or receive reimbursement from Medicare and other payers.

Malpractice 52

Malpractice Licensing Regulatory Compliance Hospitals 52

The Health Law Firm Blog

SEPTEMBER 8, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.].

Licensing 52

Licensing Governance Health Care Lawyers Medicaid 52

The Health Law Firm Blog

OCTOBER 15, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.].

Licensing 52

Licensing Doctors Nurses Medicare 52

The Health Law Firm Blog

OCTOBER 14, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.].

Licensing 52

Licensing Doctors Nurses Medicare 52

The Health Law Firm Blog

JUNE 14, 2024

Proper documentation of client treatment records is crucial for defending against malpractice lawsuits, licensing board complaints, ethics complaints and Medicare or [.]

Malpractice 52

Malpractice Licensing Medicare Medicare 52

YouCompli

APRIL 27, 2022

The Nurse Licensure Compact (NLC) is an interstate agreement allowing nurses to practice in multiple states with one multistate license issued from their home state. The compact enables nurses to provide nursing services to patients located in other NLC states via telehealth without obtaining additional licenses.

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Compliance Officers Licensing Nurses Compliance 52

The Health Law Firm Blog

SEPTEMBER 8, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.].

Licensing 52

Licensing Governance Health Care Lawyers Medicaid 52

MedTrainer

MAY 7, 2024

This blog will highlight how credentialers can navigate UnitedHealthcare provider enrollment. Built-in Automation: Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration. It’s a challenge.

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Malpractice Licensing Medicaid Medicaid 52

MedTrainer

MAY 30, 2024

Traditionally, credentialers call the appropriate entities to verify transcripts, licenses, etc. Multiple Data Sources : Information comes from state licensing boards, educational institutions, previous employers, and professional organizations. Many other challenges in the process require organization, persistence, and documentation.

Licensing 52

Licensing Malpractice Medicare Medicare 52

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). With a few exceptions, the Final Rule is a wholesale codification of the proposed rule.

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Medicare Medicare Medicaid Medicaid 52

MedTrainer

APRIL 11, 2024

This blog will discuss potential healthcare credentialing challenges, strategies to prevent these problems, and how credentialing software makes the process efficient and effective. Noncompliance: Providers must maintain specific licenses and certifications to provide patient care services. What Is Healthcare Credentialing?

Licensing 52

Licensing Medicaid Medicaid Medicare 52

The Health Law Firm Blog

NOVEMBER 1, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry [.].

Licensing 52

Licensing Doctors Nurses Medicare 52

MedTrainer

MAY 10, 2024

It can also be a prerequisite for enrolling with an insurance network or Medicare for the first time. Here’s what a typical credentialer’s workflow looks like: Like other providers, mental health professionals must be licensed in states where they offer services and enrolled with payers doing business in those areas. Effective Jan.

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Licensing ACA Medicare Medicare 52

Healthcare Law Blog

FEBRUARY 28, 2023

On February 13, 2023, the Centers for Medicare and Medicaid Services (CMS) published the revised List of Telehealth Services for Calendar Year (CY) 2023 (List). The List includes the services that are payable under the Medicare Physician Fee Schedule when furnished via telehealth.

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Medicare Medicare Nurses Licensing 52

The Health Law Firm Blog

NOVEMBER 18, 2023

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.]

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Medicare Medicare Hospitals Governance 40