Those people who make the decision to become a physician know from the outset that it won’t be an easy endeavor, as the process requires a substantial investment of time, money and energy. Nevertheless, all this hard work ultimately pays off once they have their medical license, as they are free to start caring for…
Regulators who administer and police medical payment programs (most centrally, Medicare) often — in fact, routinely — speak of the great challenges they confront in identifying and preventing provider-related fraud, as well as punishing transgressors who engage in fraudulent billings and other unlawful activities. Often, their complaints and diatribes target the sheer size of government…
Unquestionably, we live in an age of cutting-edge and quickly evolving technologies, with that reality transforming life in fundamental ways. The medical industry is hardly immune from technology’s seismic effects, of course. On the plus side, astonishing advances in medical tools and equipment have revolutionized operating rooms and treatment therapies. On the down side, though…
Some select industries are just different. Like sumo wrestling, aerial acrobatics and space exploration. And, to be sure, the health care industry. Indeed, perhaps no other realm of focus and professional endeavor is so clearly singular and distinct as the medical field. And for good reason. The industry is marked by specialized and highly trained…
According to the Kaiser Family Foundation, Medicare spending for 2016 is expected to reach $560 billion and is projected to continue to increase exponentially with Medicare spending costs soaring to $866 billion by 2024. If these projections are accurate, there’s growing concern among many economists that the Medicare program will soon be insolvent. In an…
On April 11, the Centers for Medicare & Medicaid Services (CMS) announced its largest-ever initiative to, in its words “transform and improve how primary care is delivered and paid for in America”. The effort, the Comprehensive Primary Care Plus (CPC+) model, will be implemented on January 1, 2017 in up to 20 regions. It will…
While, thankfully, reports of kidnappings and hostage takings are extremely rare on U.S. soil, U.S. companies and governmental entities are increasingly becoming targets of extortion cyber attacks called rasomware attacks. Using encryption viruses that are often disguised as email links or attachments, would-be thieves are able to access “compromised computer files” and essentially hold them…
The complex nature of billing practices within the health care field makes it particularly vulnerable to errors and possible acts of fraud. In cases where a hospital or nursing home employee believes that an employer is engaging in dishonest financial practices aimed to defraud the federal government, a lawsuit may be filed under the False…
Has your insurance company denied coverage or reimbursement of you or your family member’s mental health or substance abuse service claims? In light of the recent New York Attorney General settlements with insurance companies for violations of the federal and New York state mental health parity laws, insurance companies need to take a hard look…
The rise of social media has forever changed not only how individuals communicate with one another in their personal lives, but also how businesses communicate to and with consumers. Traditionally viewed as a more informal and personal means of communication; hospitals, nursing homes and other health care facilities must walk a fine line when attempting…