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Recent Changes to Medicare “Incident To” Billing Rules

Posted on March 2, 2017 by

Medicare permits a physician to bill for certain services furnished by a nurse practitioner or other auxiliary personnel under what is referred to as the “incident to” billing rules.  The “incident to” rules permit services or supplies furnished as an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis […]

The Case of the Very Very Impossibly Long, Terrible, Horrible, No Good, Very Bad Day

Posted on February 28, 2017 by

How Fraud and Abuse Cases Arise in a Medical Practice It is no secret many doctors work very long days.  Some days are worse and some are better than others.  As a compliance lawyer, my job is to attempt to prevent doctors from having Terrible, Horrible, No Good, Very Bad Days.  In my experience, this […]

Employee Absenteeism Due to Disability: What are Reasonable Accommodations?

Posted on February 28, 2017 by

One of the most troubling issues faced by human resource professionals is how to address an employee with a disability that impacts their ability to report for work.  A good example is an employee who suffers from episodes of depression that affect the employee’s ability to come to work.  It is almost impossible to challenge […]

Harassment Discrimination Covers the Waterfront

Posted on February 28, 2017 by

We have always been concerned about the extent to which employees or the Equal Employment Opportunity Commission (EEOC) could claim they were suffering from harassment in the workplace.  Recent guidance from the EEOC clarifies its position regarding the extent of the types of harassment that could occur and for which employers will be held responsible.  […]

Are You a Joint Employer? Watch Out for Potential Liability

Posted on February 28, 2017 by

Many businesses today use other entities to provide employees for their business operations.  This type of structure is often viewed as a good way for a company to avoid many of the pitfalls of being an employer under state and federal laws.  A recent court ruling has redefined what it means to be a joint […]

Chiropractic Service Overpayment for Lack of Medical Necessity

Posted on February 27, 2017 by

Recent OIG Release Emphasizes Need for Compliance Policies Specific to Provider Risks The Office of Inspector General recently published results of its audit of Medicare claims for chiropractic services made by a chiropractic group in Kansas.  The review concluded the groups received over $725,000.00 in overpayments in calendar years 2011 and 2012. In its report, […]

Department of Justice Issues Principles of an Effective Compliance Program

Posted on February 23, 2017 by

The Department of Justice issued a directive entitled “Evaluation of Corporate Compliance Programs.”  The document provides insight into the analysis used by the DOJ to assess the effectiveness of a corporate compliance program when making sentencing recommendations under the United States Sentencing Guidelines. The document references the Principles of Federal Prosecution of Business Organizations included […]

Autodialing and Pre-Recorded Messages: the TCPA’s Trap for Unwary Lenders and Debt Collectors

Posted on February 23, 2017 by

In February 2015, a federal judge approved a $75 million Telephone Consumer Protection Act (“TCPA”) class settlement involving Capital One and three debt collectors.[1] The plaintiffs (debtors) alleged that Capital One and debt collectors called their phones to collect credit card debts using an automatic telephone dialing system or an artificial or pre-recorded voice without […]

House Republicans and Trump Administration File Joint Motion to Delay Suit Challenging Obamacare Subsidies

Posted on February 23, 2017 by

An interesting development transpired Tuesday, February 21, 2017 in a case pending in Federal District Court in the District of Columbia that challenges subsidy payments from the Federal Treasury to support Obamacare.  The case was originally filed by House Republicans in 2014 challenging the constitutionality of the Obama administration’s authorization and payment of funds from […]

CMS Recommendations Regarding Protection from Cybersecurity Risks

Posted on February 22, 2017 by

On January 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued Recommendations to Providers Regarding Cyber Security.  In general, the Recommendations are intended to remind providers and suppliers to keep current with best practices regarding mitigation of cybersecurity attacks.  The Recommendations contain an interesting discussion of some of the current cyber threats that […]