Medicare and Medicaid fraud is one of the most serious risks healthcare providers face today. Whether it’s a simple billing error or a larger compliance issue, any mistake can quickly lead to audits, financial penalties, or even criminal charges. That’s why preventing fraud before it happens is key. What Medicare and Medicaid Fraud Looks Like Medicare and Medicaid fraud happens when someone...
Stem cell treatments have long been a topic of debate within the medical and regulatory fields, balancing potential breakthroughs in medicine with questions of safety, ethics, and oversight. A recent proposal in Florida, brought forth through a Committee Substitute for House Bill 1617, has reignited that debate by challenging existing FDA guidelines and seeking to carve a pathway for expanded...
Employee terminations in the healthcare industry come with unique challenges. Unlike other workplaces, healthcare organizations must consider patient safety, HIPAA compliance, and regulatory risks when terminating an employee. A poorly handled termination can result in lawsuits, compliance violations, and operational disruptions. Understanding the legal and procedural aspects of employee...
It’s a holy grail of health care: forcing the industry to reveal prices negotiated between health plans and hospitals — information that had long been treated as a trade secret. And among the flurry of executive orders President Donald Trump signed during his first five weeks back in office was a promise to “Make America Healthy Again” by giving patients accurate health care prices. The goal is...
The Health Insurance Portability and Accountability Act (HIPAA) Breach Notification Rule is a critical component of healthcare compliance in the United States, mandating that covered entities and their business associates promptly notify affected individuals, the Department of Health and Human Services (HHS), and, in certain cases, the media, following a breach of unsecured protected health...
The Stark Law and Anti-Kickback Statute (AKS) are two key regulations aimed at preventing fraud and abuse in healthcare. Non-compliance with these laws can result in severe penalties, including fines, exclusion from federal healthcare programs, and reputational harm. Understanding these laws and taking proactive steps can help protect your practice and ensure compliance. Stark Law Compliance The...
