Insights & Analysis
Practical guidance on PBM audits, federal investigations, compounding defense, DEA enforcement, telehealth compliance, and the regulatory pressures facing pharmacies and providers nationwide.
More articles — Page 20
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Prescribing Stimulants by Telehealth: DEA and State Exposure
Telehealth prescribing of Schedule II stimulants for ADHD runs on a temporary DEA extension, and a November 2025 conviction shows…
Peptide Compounding: Which Substances Are on FDA's Category 2 List
Five peptides carry FDA's Category 2 safety flag. A different set FDA's committee reviewed in July 2026 remains unlisted nominatio…
Hospice Six-Month Prognosis: What Auditors Need to See in the Record
Medicare reviewers test the six-month hospice prognosis against clinical decline markers, not the diagnosis code on the claim.
Hospice Face-to-Face Encounters for Recertification
A hospice recertification is incomplete without a timely, properly attested face-to-face encounter, and a missed one denies the wh…
Hospice Election Statements: The Errors That Void a Benefit Period
The elements a hospice election statement needs, the addendum CMS made mandatory October 1, 2026, and the filing errors that put a…
CCM for Nursing Home and Senior Living Residents
Medicare bars chronic care management billing during a resident's Part A covered stay because the facility is already paid for tha…
Can RPM Be Billed for Skilled Nursing Facility Residents
Whether RPM is billable for a skilled nursing facility resident turns on Part A status, the consolidated billing exclusion, and pl…
New Jersey Medicaid Audits by the Office of the State Comptroller
How the NJ Office of the State Comptroller's Medicaid Fraud Division audits providers, from document requests through the appeal d…
Medicaid Audits of Nursing Homes: Level of Care and Eligibility
State Medicaid auditors test whether nursing facility residents meet PASRR and level-of-care eligibility, not just billing documen…