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Post-COVID Medicare and Medicaid Provider Audits Are Here!
My esteemed colleagues with curious minds, today we embark on a journey into the complex world of Medicare and Medicaid provider audits, specifically orchestrated by the enigmatic entities known as...
View ArticleMedicaid Expansion Set To Take Effect In North Carolina Today!
The AP (11/30, Schoenbaum) reports that “hundreds of thousands of adults in North Carolina” are set to receive Medicaid benefits, “a development that boosters say will aid hospitals and local...
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CMS Issues Interim Rule in Response to State Medicaid Disenrollment Trend
When the COVID-19 Public Health Emergency (PHE) ended in April 2023, the Families First Coronavirus Response Act’s Medicaid continuous enrollment condition also came to an end. The condition had...
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Knicole Emanuel Presents Webinar January 25, 2024!
A Guide to the RAT-STATS Statistical Software in Medicare and Medicaid Hosted by: Lorman Click here to register for the webinar on January 25, 2024, from 1:00pm-2:30pm! Join Nelson Mullins Raleigh...
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Physician Acquitted Due to Ambiguous and Subjective E/M CPT Codes!
Happy 2024! Today I want to discuss subjectivity and e/m codes. How many times have we heard horror stories surrounding the billings of 99204 versus 99205? We all know that the definitions of e/m...
View ArticleMedicare Can Force a Whistleblower to Dismiss When Smoking Gun is Smoke and...
2024 has already proven to be audit heavy. It seems that the repercussions of COVID are beginning to appear. Actions related to COVID, such as audits of dates of service (“DOS”) during COVID are...
View ArticleIn Medicare Provider Audits, the Best Defense Is a Good Offense
Today I want to discuss upcoming 2024 audits. It has been almost four years since the world shut down due to COVID. Life has been divided into “before COVID” and “after COVID.” Before COVID, the...
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Beyond Malpractice: Cultivating Trust and Safety in Health-Based Services
Today’s blog post is from a guest blog poster, Teresa Greenhill. Teresa Greenhill is the co-creator of MentalHealthforSeniors.com, which is dedicated to providing seniors with information on physical...
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Two Success Stories: (1) Getting a Provider’s Suspension of Medicaid...
A quick shout out to NC State University, my undergraduate alma mater, who won the ACC Tournament, beating out #1 ranked UNC!!! I love legal success stories too. Because when my team wins, health care...
View ArticleFederal Court Vacates Two, Medicare ALJ Decisions with Extrapolations
Today is April Fool’s Day, but the story I am going to tell you today is no prank. On 03/25/2024, the U.S. District Court of the Southern District of Florida rendered its Decision on MedEnvios...
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