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CMS Audit Practices: How false can you get?

Caring Hearts Personal Home Care Services provided physical therapy and skilled nursing services to homebound Medicare patients. During an audit, CMS determined that Caring Hearts provided services to patients who didn’t...more

Technology and the Future of Cities: Oklahoma City's Innovation District: The new knowledge hub

Civic and community leaders in Oklahoma City are developing an Innovation District. An Innovation District is a development based on the premise that economic growth, job creation, and innovation can be fostered through the...more

Stark: A Stagnant Law For An Evolving Industry

The Stark Law was originally enacted by Congress in 1989 as the Ethics in Patient Referrals Act. Initially, it prohibited a physician from referring Medicare beneficiaries to clinical labs in which the physician had an...more

Payment is due at the time services are rendered

Typically, physicians collect co-payments from patients when services are provided, submit claims for reimbursement to government and commercial payers, and then send bills to patients for the balance owing. The payment and...more

The skinny on narrow networks

The insurance exchanges created under Affordable Care Act have facilitated increased competition. Old version managed care models implemented cost-savings measures like pre-authorizations for medical care, hospital length of...more

Physicians as whistleblowers: Doctors get rich by exposing fraud

As the federal and state governments have evolved from Uncle Sam to Doctor Sam, the potential for healthcare waste, fraud and abuse has also increased. One way the government has deterred healthcare fraud is by enacting and...more

Innovation Districts

Last year representatives of a coalition of 11 organizations started meeting to discuss the continued development and expansion of Oklahoma City’s bioscience and technology sectors. Among other matters, the group discussed...more

Hospital-Physician Alignment

Hospital-physician alignment involves the effective coordination between physicians and hospitals in order to accomplish and prioritize patient care and financial goals. Those goals may relate to better patient-centered care,...more

3/3/2015  /  Healthcare , Hospitals , Physicians

Challenges Physicians Can Expect in 2015

Reimbursement for medical services continues to decline. Continuing uncertainty about the Affordable Care Act persists. Government regulations create burdensome paperwork, busywork, and compliance headaches. Technology costs...more

Oklahoma Legislature significantly expands peer review privilege

Oklahoma’s peer review statute provides that peer review information is private, confidential, and privileged. It encourages health care professionals to police themselves by evaluating their peers. It also promotes the...more

Norman Physician Hospital Organization — Factors Supporting Clinical Integration

Clinical integration is a somewhat imprecisely defined concept in the health care industry. Lawyers and health care executives have identified components and elements of clinical integration and frequently ask how many of...more

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