Archive for December 2015
AHCA streamlines Medicaid credentialing process
Healthcare providers that do not have a Medicaid provider number, but who are servicing patients through the private insurance industry, now will be able to get a Medicaid ID through a new process being implemented by the Agency for Healthcare Administration. As of Dec. 4, providers who do not hold a Medicaid ID and need…
Read MoreSCOTUS to take on implied certification liability under FCA
The U.S. Supreme Court will decide whether False Claims Act (FCA) cases may be brought by whistleblowers and the government under the theory known as “implied certification” and if so, under what circumstances. Under this theory, when a provider submits a claim for government payment, it does so with the implication that it is being…
Read MoreWith the new year comes greater HIPAA oversight
HIPAA-regulated entities can expect 2016 to be the year of increased oversight. That’s when the Health and Human Services Department’s Office for Civil Rights (OCR) begins Phase II of its audit program. The program is expected to focus on common areas of noncompliance and will include HIPAA-covered entities as well as business associates. Phase 2…
Read More