November 10, 2023 | By Toni Elhoms, CCS, CPC, CPMA, CRC On countless occasions, I have heard physicians and healthcare providers balk at the notion of learning how to level their E/M services based on medical-decision-making (MDM), and some will even go as far as to say things like “I don’t have time…
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Annual Compliance Training Requirements Written by: J. Paul Spencer, CPC, COC As a healthcare compliance professional, there have been two constant pieces of advice that I have provided for medical practices: If you do not have a compliance program, implement one, and Once you implement a compliance program, follow it. The Office of Inspector General…
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Understanding Internal Self-Referrals Written by: Ashley Morgan, Partner, Liles Parker PLLC Healthcare regulations outline legal risks related to internal self-referrals, making it important for both physicians and healthcare organizations to be informed about these issues. While internal referrals may seem like a natural part of integrated healthcare systems, they are heavily regulated under federal and…
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Cosmetic Services in Professional Fee Clinics: Compliance Considerations Written by: Jesse Overbay | Associate Director & General Cousel @ DoctorsManagement, LLC Overview of Cosmetic Services in Professional Fee Clinics Across many healthcare settings, including specialized and general clinics, an increasing number of providers are incorporating cosmetic procedures in response to patient interest and evolving treatment…
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Incident-to Billing Revisited: Chasing the 15% Written by: Shannon O. DeConda | NAMAS, a division of DoctorsManagement, LLC Incident-to billing, as defined by the Centers for Medicare & Medicaid Services (CMS), has long been both a point of interest and a source of confusion among healthcare providers. For many years, the prevailing advice among compliance…
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A Stark Law Overview for Non-Legal Minds Written by: David M. Glaser, Shareholder | Fredrikson Health Law Stark is perhaps the most difficult of health law regulations, which may explain why there are so many misunderstandings about it. The first source of confusion is that the law is commonly called an “anti-self referral law.” But…
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