Legal insights from both sides of the aisle about what to do when protected health information (PHI) has been disclosed or when law enforcement requests it in a legal proceeding.
Rachel V. Rose, JD, MBA
A recent $65M False Claims Act settlement highlights physicians' responsibility to provide the best care as well as correctly document and appropriately code it.
Providers should evaluate Anti-Kickback and HIPAA compliance simultaneously.
A look at recent lawsuits the U.S. Department of Justice has pursued for illegal upcoding, downcoding, and excessive coding claims.
Physicians participating in certain at-risk Medicare Advantage plans may be exempt from certain Merit-Based Incentive Payment System (MIPS) requirements.
A recent announcement by CMS for comments may be a welcome reprieve for physicians.
Physicians need to understand agency, the six types of authority, and their relationship to emergency departments.
A Texas physician’s indictment should serve as a reminder of the Hippocratic Oath and that honest doctors often suffer by their dishonest peers exposed in the press.
Despite express prohibition regarding the use and/or the sale of PHI by unauthorized individuals, doctors and companies still did it—and paid.
Two DOJ cases provide important reminders to physicians on listing the proper provider for claims and to meet testing guidelines.