New York health law lawyer & attorney Ilana Sable uses the Health Care Compliance Watch blog to discuss issues and information relating to medical, insurance, hospital & physician law.
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Following my post titled “Audit Defense-Part I: Monitoring Your Practices Medical Records,” I received several questions and comments concerning a medical practice’s best use of its medical records to fight audits, investigations or reviews. My answer is that the best course...
Providing Midwifery Services As Part of Your Obstetrics Practice: Benefits and Compliance Considerations
Obstetrics practices located in New Jersey and New York can increase revenue and efficiently allocate a substantial portion of their daily patient care by incorporating the services of certified midwives and/or certified nurse-midwives into their practices. Generally speaking, midwives are...
New Jersey "Health Care Professional Responsibility and Reporting Enhancement Act" Provides Immunity for Entity-to-Entity Employee Reference Requests
A persistent concern for many health care entity-employers (“Entity-Employers”) is retaliation from a disgruntled former employee after the Entity-Employer responds to a “reference request” with negative, albeit truthful, information about the former employee. Often...
Circumventing Exclusion from Insurance Carrier Networks: A Formula for the Fraudulent Practice of Medicine
Health care providers who have been excluded from participation with certain insurance carriers often approach me for guidance concerning their options (if any) for continuing their existing relationships - and possibly treatment – with patients who are insured by the “excluding”...
Providers, physicians and other suppliers who receive unfavorable overpayment determinations by Medicare Recovery Audit Contactors (“RACs”) for services and supplies provided to Medicare beneficiaries under Part A and Part B have up to five levels of appeal available to them. This...
Traditionally, it was only “doctors” that provided medical care to patients – likely with the help of some sort of unlicensed assistant – and doctors would, therefore, limit their billing (and revenue) to the services that they, individually, provided. In recent years...
Over the past few years health care providers have reported an increasing surge in the outsourcing of medical billing and collections to third party medical billing companies. The outsourcing surge stems from a number of factors, most of which...
Appearance enhancement and weight loss businesses that involve licensed professionals or that require a specialized business license will face complicated regulatory considerations when franchising their business. These regulatory considerations are heightened in states with strong...
Four Steps that Health Care Providers Must Take When Employing or Contracting With Employees, Physicians, Vendors and Other Affiliated Parties
Health care providers participating in governmental health care programs, including Medicare or Medicaid, must confirm, when employing or contracting with a physician, employee, vendor or other affiliated party, that the individual or entity is not excluded from participation in any governmental...
Daniel Cook of Outpatient Surgery Magazine recently reported on a pending New Jersey State bill that may effectually close many single-room surgery centers in the State of New Jersey. On May 26, 2011, the New Jersey State Senate introduced an amended bill that proposes to increase...