Legal Insights

For DME suppliers, a letter from a Unified Program Integrity Contractor (UPIC) is not a routine records request; it's a high-stakes fraud investigation that can trigger payment suspensions and threaten your company's survival. Our latest article explores the aggressive tactics of these powerful auditors, identifies the specific CMS contractors that monitor and police the industry, and details the common billing patterns that can place your business directly under their microscope. Read our guide to understand the immense financial risks of a UPIC audit and learn how to prepare for and respond to this critical business threat.

In a CMS audit, your documentation is your only defense. A missing signature or an incomplete progress note can lead to a costly overpayment demand. Is your record-keeping system truly protecting you? This article provides a blueprint for creating an audit-proof documentation system. We cover everything from intake checklists to monthly note requirements for wound care supplies, helping you ensure every claim is fully supported and ready for scrutiny.

Health Law Alliance is proud to announce a major victory in federal court, where it successfully secured the immediate lifting of a DEA suspension against a Florida community pharmacy, restoring its full authority to dispense controlled substances. This outcome ensures uninterrupted patient care and underscores the firm’s commitment to protecting healthcare providers from government overreach.

Federal enforcement actions are increasingly focused on remote patient monitoring (RPM) services. In this article, we break down two recent settlements involving RPM companies—Health Wealth Safe and Capital Health—and discuss key compliance takeaways for telehealth providers.

The DEA is increasingly targeting ketamine providers with record-keeping inspections and audits, making expert Medicare and DEA compliance defense essential to avoid steep fines and license risks.

The feature underscores HLA’s mission to elevate thought leadership within the healthcare space and provide trusted expertise on issues that directly impact patients, providers, and policymakers.

DME suppliers can prevent unexpected and costly license revocations by strategically applying with a "By Appointment Only" designation. This article explores the common compliance trap of failing unannounced site visits due to conflicts between standard pharmacy operating hours and Medicare's "posted hours" requirement for DME suppliers. "By Appointment Only" status is a crucial safeguard, which suppliers can take to implement to protect their DME billing privileges.

Pharmacists must resolve “red flags” under the Controlled Substances Act’s corresponding-responsibility requirements before dispensing controlled substances. Overlooking warning signs, such as cash-paid, high-dose opioid prescriptions—can now trigger False Claims Act liability and massive penalties, as demonstrated by Walgreens’ $350 million settlement in April 2025.

On July 11, 2025, the 9th Circuit upheld a laboratory operator’s convictions for violating EKRA by paying marketing agents to mislead providers into providing patient referrals for medically unnecessary blood tests. In this article, we analyze the 9th Circuit’s ruling and what it means for the future of EKRA enforcement.