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CMS clarifies 60-day overpayment rule

The Centers for Medicare & Medicaid Services (CMS) has published its long-awaited final rule that details the reporting and returning ...
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TRICARE Billing Scandal Intensifies as Feds Target More Compounding Pharmacies

Allegations of fraudulent billing practices involving compounding pharmacies and specialty creams is rearing its ugly head again. Now, the U.S. ...
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Social media posts can be used to detect healthcare fraud

In George Orwell’s novel Nineteen Eighty-Four, citizens of Oceania, a totalitarian state, are under surveillance at all times and constantly ...
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Firm partners with LicenseLogix to assist clients with business licensing needs

As many business owners know, or often find out as they are launching their business, there are many rules and ...
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Legal issues relating to telemedicine expected to increase

While the days of the Marcus Welby house call have, for the most part, been relegated to the history books, ...
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GAO Report: HHS Lacks Adequate Healthcare Workforce Planning

The Department of Health and Human Services (HHS), which engages in planning for the 72 healthcare workforce programs administered by ...
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How data mining is uncovering healthcare fraud

What does your data say about your healthcare practice? Does it show that you bill considerably more than your colleagues ...
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Finalized DME rule targets fraud, abuse

The Centers for Medicare and Medicaid Services has finalized a rule that creates a prior authorization process for some durable ...
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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, ...
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SCOTUS 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 ...
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