September 2022 |
  • Blog

Measuring Compliance Program Effectiveness: A Resource Guide

On March 27, 2017, the Office of the Inspector General (OIG) posted a 52 page comprehensive document entitled, “Measuring Compliance Program Effectiveness: A Resource Guide.” The Resource Guide can be…

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September 2022 |
  • Blog

ZPIC Audits: What To Know

Medicare Contractor Background The Medicare Program is the federal health care program designed to insure the elderly and the disabled. The Program is administered by the Center for Medicare and…

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September 2022 |
  • Blog

The Death of the Home Health Pre-Claim Review Demonstration?

Why Home Health For years the home health care industry has been viewed by government regulators as a breeding ground for fraud and abuse. In 2016 HHS OIG released a…

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September 2022 |
  • Blog

Six People Convicted of Medicare Fraud for Falsifying Records in Louisiana

A jury in New Orleans found six people guilty of Medicare fraud on May 10, 2017. The defendants worked for Abide Home Care and falsified records and certified beneficiaries for…

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September 2022 |
  • Blog

Owners of Drug Testing Laboratory Arrested in Palm Beach

Authorities have arrested the owners of a Delray Beach drug testing laboratory on charges they bribed a sober-home owner with at least $150,000 so his residents would undergo lucrative drug…

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July 2022 |
  • Blog

Fraud Concerns in Employer Self-Funded Health Plans

Self-funded insurance plans create an avenue for employers to explore a lower overall health care cost to its employees. These plans give an employer the flexibility to customize a health…

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May 2022 |
  • Blog

Laboratory Enforcement Trend – Strategic Use of Immediate Jeopardy Findings in Fraud, Waste and Abuse Investigations

In recent years, we have observed an increasing trend of immediate jeopardy findings (nominally based on operational deficiencies) that appear to be stop-gap measures preventing laboratories that are the targets…

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May 2022 |
  • Blog

Misinterpreting EKRA and the Dangers of “Flat Fee” Independent Contractor Marketing

Since the enactment of the Eliminating Kickbacks in Recovery Act (“EKRA”), we have a seen a significant industry shift away from labs using an employed and commissioned sales force in…

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