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 25
Page 25 of 113 · 1018 articles
Board of Nursing Investigations: What a Nurse Should Expect
A board of nursing investigation can start from an employer report, a patient complaint, a self-report, or a criminal record match…
Upcoding Allegations Under the False Claims Act
Upcoding probes move from peer-comparison data to a sampled chart review. What separates a billing error from False Claims Act lia…
Georgia Board of Pharmacy Investigations and Licensing Disputes
How Georgia's Board of Pharmacy investigates licensees, from GDNA inspections through a contested case hearing and judicial review…
The New Jersey False Claims Act for Healthcare Providers
New Jersey's own False Claims Act runs alongside the federal statute, with its own relator rules, limitations period, and subpoena…
State Medicaid Exclusion Lists: Screening Beyond the Federal LEIE
Several states publish their own Medicaid exclusion or sanction list separate from the federal LEIE, and screening only one can mi…
The CMS Self-Referral Disclosure Protocol for Stark Violations
How a provider discloses a Stark Law violation to CMS, what the SRDP submission must contain, and how CMS decides whether to reduc…
Appealing a Medicare Wound Care Overpayment Determination
Rebutting a Medicare wound care overpayment claim by claim: measurements, debridement depth, conservative care, product selection,…
The Civil Monetary Penalties Law: OIG's Own Enforcement Track
OIG's Civil Monetary Penalties Law lets it fine and exclude providers administratively, even after DOJ declines to prosecute the s…
A DUI Arrest and Your Nursing License
A DUI arrest can trigger board, employer, and renewal reporting duties that attach at different points, and vary by state.