Search Results: compliance expert
CMS Issues Final Rule Requiring Overpayments Within 60 Days
The CMS Overpayment Rule The Centers for Medicare and Medicaid Services (CMS) recently issued a final rule requiring Medicare Parts…
Avoiding Problems With GSA Debarment Hits: Best Practice Tips to Mitigate Sanction Screening Problems
The Excluded Parties List System (EPLS) is now part of the System for Award Management (SAM), which is maintained by…
When Moving to a Corporate Integrity Agreement, Think Ahead to Avoid Problems Later
Recent high-profile cases involving Corporate Integrity Agreements (CIAs) such as Tuomey Healthcare System and Millennium Health (formerly Millennium Labs) remind…
False Claims Act Whistleblowers Lead to $2.8 Billion in Recoveries
The DOJ reported that the Civil Division recovered $2.8 billion in fiscal year (FY) 2015 as a result of 638…
Independent Auditor (IA) Validation Process for Medicare Part C and D Program Audits
CMS has issued an updated memorandum mandating an Independent Auditor (IA) Validation Process for Medicare Advantage and Prescription Drug Plan…
Stark Law Final Rule Summary
CMS recently issued the Stark Law Final Rule (“Final Rule”), which makes numerous significant changes and provides important clarifications to the…
Remembering Our Friend William Moran
It is with great sadness that our dear friend, mentor, and colleague, William (“Bill”) Moran, passed away after a long…
HIPAA Interim Privacy Officers
Interim Privacy Officers from Strategic Management The HIPAA Privacy Rule requires a covered entity to designate a Privacy Officer responsible…
Data Breaches Continue To Increase
After a decade of HIPAA Privacy and Security efforts, data breaches continue to increase. The year 2015 represents a banner…
Tips For Managing Medicare Claims Appeals
Managing Medicare claims appeals continues to be a heavy burden for providers. In light of the Office of Medicare Health…
New Report Finds Excluded Providers Still Participating In Medicaid Programs
On August 5, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released a surprising…
OIG Finds That Barred Providers Are Still Billing Medicaid
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported that hundreds of Medicaid providers that…