ZPIC Audits

ZPIC Prepayment Review

From LilesParker.com I.     ZPIC Prepayment Reviews: Over the last year, Zone... 

OIG Cautions About ZPIC Conflict of Interest

From LilesParker.com ZPICs Have Conflict of Interest HHS-OIG recently released a... 

Liles Parker Interviewed About SNF ZPIC Audits

Michael Cook and Robert Liles, partner and managing member of Liles Parker, respectively,... 

Beware of HHA Compliance Risks in TX and OK

I.  HHA Compliance Background: Over the past few weeks, several important events... 

ZPIC Audit – Ten Recommendations for Audit Preparation

ZPIC Audit Introduction Has your Practice, Home Health Agency, Hospice, DME Company... 

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Medicare Audits

Scrutiny Lingers for Texas HHAs

I.     HHS-OIG Report Concerning Texas HHAs. A recent report by HHS-OIG found... 

Liles Parker Interviewed About SNF ZPIC Audits

Michael Cook and Robert Liles, partner and managing member of Liles Parker, respectively,... 

Beware of HHA Compliance Risks in TX and OK

I.  HHA Compliance Background: Over the past few weeks, several important events... 

MACs Flex Their Muscles with Recent CERT Audit Findings

I.  What is a CERT Audit? The “Comprehensive Error Rate Testing” (CERT) program... 

5 Fundamental Medicare Compliance Concepts

Introduction to Medicare Compliance There are “rules of life” we have learned... 

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HEAT Enforcement

South Texas Health Care Providers Remain Under Considerable Scrutiny by HEAT Prosecutors and Investigators – Compliance Isn’t Optional – It’s Essential in 2011.

(January 6, 2011):  Three Houston-area residents, one of whom is a physician, were sentenced to prison on January 4th for their roles in a multi-million dollar durable medical equipment (DME) Medicare fraud scheme.  Each of the three defendants were also ordered to pay restitution to the Federal government, in amounts ranging from $29,052 to $1.4... [Read more of this review]

Home Health Agency “Patient Recruiter” Sentenced to 63 Months in Prison for Allegedly Committing Health Care Fraud

(October 18, 2010):  The U.S. Attorney’s Office for the Eastern District of Michigan, working with the FBI and HHS-OIG has announced the sentencing of yet another defendant convicted of home health fraud.  As the Department of Justice’s Press Release reflects, the defendant, a nurse who worked as a “patient recruiter“ and operator... [Read more of this review]

President Obama’s 2011 Funding Request Provides for Expansion of the HEAT Program to Additional Cities

(October 4, 2010):  As DOJ has recently noted in its own blog, over the last Fiscal Year, DOJ (including its 94 U.S. Attorneys’ Offices),  HHS’ Office of Inspector General (HHS-OIG), and the Centers for Medicare and Medicaid Services (CMS), have been extraordinarily active in jointly pursuing  health care providers allegedly engaging in fraud... [Read more of this review]

Medicare Fraud Strike Force Operation Leads to Charges against 94 Defendants, including 4 in South Texas

(July 17, 2010): Yesterday, the Department of Justice (DOJ) announced charges against 94 physicians, medical assistants, and health care company owners and executives in connection with alleged false Medicare claims amounting to more than $251 million.  24 defendants from Miami account for approximately $103 million of that amount.  Four defendants... [Read more of this review]

Texas Psychiatrist Indicted and Arrested

(July 9, 2010):  On June 14, 2010 the U.S. Attorney’s Office for the Western District of Texas announced that a Federal Grand Jury had returned a 99-count indictment against a pain management physician who operated clinics in San Antonio and El Paso.  The physician was charged with 21 counts of health care fraud, 20 counts of false statements relating... [Read more of this review]

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