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These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

While it is important to carefully consider the most effective methods of providing care and the intended purpose behind various reimbursement, privacy, and fraud and abuse regulations, it is also clear that healthcare delivery has always and continues to evolve, and the regulatory framework needs to do the same. Federal rules.

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Treatment Center Plead Guilty to Anti-kickback Statute Violations Involving Alcohol and Drug Addiction Treatment Centers

Health Law Blog

Substance Abuse Treatment Center Fraud Scheme Results in Guilty Plea. The Department of Justice recently announced the guilty plea of two individual alcohol and substance abuse treatment center owners for their participation in what DOJ labeled a “multi-million dollar health care fraud and money laundering scheme.”

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Post-Acute Compliance Program Update: OIG Proposes Amendments to Exclusion Rules

Hall Render

The Proposed Rule would remove the aggravating factors which permit OIG to lengthen periods of exclusion based on the loss of the individual’s or entity’s health care license, and the mitigating factors, which OIG could consider if aggravating factors are applied.

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Introduction to Telebehavioral Health

AIHC

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. This compact does not apply to nurse practitioners (NPs) because they are licensed under state boards of nursing and not medicine.

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Fundamentals of a Healthcare Internal Business System Audit

AIHC

Third-party audits may result in certification, registration, recognition, an award, license approval, a citation, a fine, or a penalty issued by the third-party organization or an interested party. Corrective action includes refunding overpayments revealed during the audit. This typically involves conducting Root Cause Analysis.

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New Jersey Appeals Court Says Plaintiffs Don’t Need Presuit Affidavits to Sue LPNs in Medical Malpractice Cases

The Health Law Firm Blog

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.]

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Florida Attorney Says AHCA Must Put Medicaid Final Orders Online

The Health Law Firm Blog

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Florida's Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against [.]