Most U.S. Department of Justice (DOJ) investigations do not end up in court. Defendants who lose a civil case risk large fines and penalties, while
In the months leading up to a presidential election, when there is a chance that the White House may change occupants after November, administrations often
The bad news just keeps on coming for Martin’s Point Healthcare in Portland, Maine. The lawsuit includes a group of healthcare centers and also a
A couple of weeks ago, the Federal Trade Commission (FTC) held a three-hour webinar on the problems with private equity in healthcare. In this article,
Let’s start with some history because it’s the only way to make sense of why I’m writing about U.S. Supreme Court cases related to commercial
As regular listeners to Monitor Monday know, my segments typically focus on cases alleging healthcare fraud against health insurance companies, hospitals, or physician groups, initiated
On Oct. 12, the U.S. Department of Justice (DOJ) announced that it had entered into a historic $85 million settlement with Cardiac Imaging Inc., a
A colleague of mine recently asked, “what does it take for a doc to get sent to prison?” I had to confess: I really didn’t
In March, the U.S. District Court in the Northern District of Texas vacated the requirement that Patient Protection and Affordable Care Act- (PPACA)-compliant health plans
The government has been cracking down on pharmaceutical companies’ nefarious use of charities to steer Medicare patients toward more expensive drugs, costing taxpayers millions of
Information is provided in a breakdown of the annual HHS-DOJ fiscal report. On July 27, the U.S. Department of Health and Human Services (HHS) and
Allegations were made of kickbacks in the form of co-pay waivers. Late last month, US WorldMeds, a pharmaceutical manufacturer, agreed to pay the U.S. Department
Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.
Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.
Hospitals face growing challenges in measuring observation metrics due to inconsistencies in classification, payer policies, and benchmarking practices. Join Tiffany Ferguson, LMSW, CMAC, ACM, and Anuja Mohla, DO, FACP, MBA, ACPA-C, CHCQM-PHYADV as they provide critical insights into refining observation metrics. This webcast will address key issues affecting observation data integrity and offer strategies for improving consistency in reporting. You will learn how to define meaningful metrics, clarify commonly misinterpreted terms, and apply best practices for benchmarking, and gain actionable strategies to enhance observation data reliability, mitigate financial risk, and drive better decision-making.
The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s third quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s second quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance on the ICD-10-CM/PCS code updates effective with discharges and dates of service on or after 4/1/2025. Kay Piper reviews and updates coders on Obesity, COVID-19, and ICD-10-PCS coding guidelines in the AHA’s first quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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