Healthcare compliance is a broad term that can encompass issues such as actual practice procedures that can lead to malpractice claims, all the way to billing compliance.
Our firm’s scope of healthcare compliance only deals with billing as it pertains to Medicare and Medicaid; then, the collateral effects including Stark Law, kick-backs and related matters.
The five most important Federal fraud and abuse laws that apply to physicians are the False Claims Act (FCA), the Anti-Kickback Statute (AKS), the Physician Self-Referral Law (Stark law), the Exclusion Authorities, and the Civil Monetary Penalties Law (CMPL). Government agencies, including the Department of Justice, the Department of Health & Human Services Office of Inspector General (OIG), and the Centers for Medicare & Medicaid Services (CMS), are charged with enforcing these laws. As you begin your career, it is crucial to understand these laws not only because following them is the right thing to do, but also because violating them could result in criminal penalties, civil fines, exclusion from the Federal health care programs, or loss of your medical license from your State medical board.
Some of our clients keep us on retainer to solve their ongoing controversies and questions with billing and employment matters, whereas some of our other clients bring us on board for limited representation such as medicare and medicaid audits. Call us to discuss your needs.
Health Care Compliance Atlanta
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Medicare Fraud Attorney Atlanta
Medicare Fraud Attorney Atlanta If you have been charged with medicare fraud, contact our office to discuss you options and rights. What is now considered the largest single instance of medicare fraud took place in Decatur, just outside of Atlanta. The U.S. Attorney is seeking charges related to doctors and…
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Atlanta Dentist Medicaid Fraud Attorney
Atlanta Dentist Medicaid Fraud Attorney If you have been arrested for Medicaid fraud in Atlanta, contact our office to understand your rights and options. A $1M fraud was just invested by the U.S. Attorney's office in October of this year. Dr. Oluwatoyin Solarin, who had offices in Doraville and Duluth,…
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Medical Necessity and RAC Audits
Medical Necessity and RAC Audits What is a medical necessity? According to a RAC Auditor (RA), it is something that is justifiably reasonable and necessary according to evidence-based clinical standards of care. According to who? Is this one-size fits all? How is this even possible? If you are not scratching…
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Red Flags In Physical Therapy RAC Audits
Reg Flags In Physical Therapy RAC Audits Even if you're not currently under a RAC Audit, you might be wondering just how to stay out of trouble or not be "flagged" for an audit. As much as you might have heard about the random nature of an audit, experience tells…
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