News & Analysis as of

Auditors Centers for Medicare & Medicaid Services (CMS)

Health Care Compliance Association (HCCA)

[Event] Healthcare Enforcement Compliance Conference - November 18th - 20th, Arlington, VA

Is your compliance strategy aligned with current enforcement priorities? Hear first-hand from government enforcement leaders about regulatory changes, expectations, and key areas of concern. Gain insight into current...more

Oberheiden P.C.

What Does it Take to Win Medicare Appeals in 2024?

Oberheiden P.C. on

Lots of health care service providers find themselves in the position of needing to file a Medicare appeal. Despite the systematic nature of modern Medicare billing, wrongful denials remain common, and errors during Medicare...more

K&L Gates LLP

What's Been Missing: District Court Orders the Government to Produce Complete Universe of Claims in Provider's Due Process...

K&L Gates LLP on

On 5 March 2024, in an issue of first impression in the District of South Carolina, a district court judge overseeing judicial review of a final agency decision in a Medicare claims appeal ordered the Government to complete...more

Oberheiden P.C.

4 Healthcare Audit Defense Strategies

Oberheiden P.C. on

If you are a healthcare provider, you are bound to get audited at some point. Who conducts that audit (this includes federal authorities such as the Department of Health and Human Services (HHS), the Center for Medicare and...more

Patrick Malone & Associates P.C. | DC Injury...

Federal auditors assail $359 million in Medicare costs for chiropractic care

Federal auditors have found that 80 percent of Medicare spending in a recent year on chiropractic care-some $359 million-was medically unnecessary. The federal insurance program for senior citizens should not have thrown...more

BakerHostetler

Children’s Hospitals Obtain Temporary Injunction Against CMS

BakerHostetler on

Challenging actions by the Centers for Medicare & Medicaid Services (CMS) under the Administrative Procedures Act (APA), Texas Children’s Hospital and Seattle Children’s Hospital obtained a preliminary injunction that enjoins...more

Baker Donelson

Audits and Appeals: A Routine Cost of Doing Business with Medicare

Baker Donelson on

The Centers for Medicare and Medicaid Services has unleashed an alphabet of auditors to identify overpayments. These auditors are armed with the authority to conduct pre-payment reviews, and post-payment audits, as well as...more

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