Month: November 2017

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Arizona Health Care Fraud & Federal Criminal Defense

Protecting Medical Professionals and Businesses in Scottsdale & Phoenix from Health Care Fraud Allegations When medical professionals, health care businesses, and pharmacies retain our team made up of former federal prosecutors, they want the advantage of courtroom dominance and trial...Read More

Are Civil Investigative Demands Public?

While the most-severe consequences of facing a civil investigative demand (CID) flow from the potential outcomes of a federal investigation, having an investigation become public can have significant practical implications for health care providers and other businesses as well. If...Read More

Understanding the Medicare Appeals Process

The Five Levels of Medicare Review for Health Care Providers When a Medicare Administrative Contractor (MAC) or other CMS contractor/agency audits your practice’s invoices, you will receive a document called a Remittance Advice (RA), containing the MAC’s initial determination. If...Read More

Civil Investigative Demand vs. Subpoena

Not all requests for information are created equal. When federal and state authorities are investigating health care providers and other entities for suspected fraud and abuse, they have a variety of tools at their disposal. Existing under varying sources of...Read More

Florida Anti-Kickback Statutes, Stark Law and Patient Brokering Act

Florida, like most other states, has enacted several laws targeting the health care industry that are similar to the federal laws that apply to physicians and other providers nationwide. As a result, providers in the state must not only develop...Read More

HIPAA Compliance

For health care providers nationwide, few laws raise more compliance concerns than the Health Insurance Portability and Accountability Act (HIPAA). Enacted in 1996, HIPAA changed the way that health care providers managed virtually all aspects of their businesses; and constant...Read More

New York City Doctors Busted in Health Care Fraud Scandal

A Shocking Case of Deception and Abuse… But Are the Allegations All Fair? As medical fraud defense lawyers, our blog frequently focuses on overzealous prosecutors and the cases in which innocent health care providers are target unfairly. There’s a good...Read More

Medicaid & Medicare Audits for Dentists

Like all health care providers and medical facilities that bill Medicaid and Medicare for reimbursement, dentists and dental practices are subject to constant scrutiny. Federal authorities including the U.S. Department of Justice (DOJ) and the Centers for Medicare and Medicaid...Read More

7 Things You Must Know About: Civil Investigative Demands (Antitrust)

In the United States, federal antitrust laws prohibit companies from engaging in commercial practices that have an anticompetitive effect on the market. Laws such as the Sherman Act include “private right of action” provisions that allow competitors and other interested...Read More

How to Manage Medical Billing Disputes

Tips for Avoiding Them as a Provider (And Handling Them When They Arise) If you treat even a handful of Medicare / Medicaid patients at your medical practice, the amount of paperwork you process back and forth with the government...Read More

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