• News Alert: Beware the ZPIC Audit

    News Alert: Beware the ZPIC Audit

    While the Federal Government has many contracted auditors to assist in identifying overpayments to health care providers, by far the most dangerous of these auditors, from the health care provider’s perspective, is the ZPIC.

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  • New Criteria For Advanced Diagnostic Imaging Services

    New Criteria For Advanced Diagnostic Imaging Services

    New reporting requirements for healthcare providers are scheduled to go into effect in January 2018 as a result of the mandate in Section 218(b) of the Protecting Access to Medicare Act of 2014 (PAMA). PAMA requires CMS to establish a program to promote ordering physicians to consult “appropriate use criteria” (AUC) prior to ordering advanced diagnostic imaging tests for Medicare beneficiaries.

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  • Healthcare Compliance Update

    Healthcare Compliance Update

    The Office of the Inspector General (OIG) recently posted new compliance guidance to assist healthcare entities of all types and sizes of measuring the effectiveness of their compliance programs. The publication, “Measuring Compliance Program Effectiveness: A Resource Guide” was the collaborative result the Health Care Compliance Association and the OIG. The resource guide provides numerous ways to measure effectiveness for each of the following elements of a compliance program:

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  • Legal Hot Topic: Healthcare

    Legal Hot Topic: Healthcare

    THE PROBLEM: Hospitals and clinics often produce a patient’s medical record multiple times and all copies are not the same; that creates problems in litigation.

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