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 31
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The FCA Knowledge Standard After SuperValu
The Supreme Court's SuperValu decision ties False Claims Act scienter to what a defendant subjectively knew, not a reasonable read…
Presenting a Defense to DOJ Before the Intervention Decision
What defense counsel submits to DOJ and agency counsel before a qui tam intervention decision, and why the work matters either way…
Voluntary License Surrender While Under Investigation
Boards generally treat a surrender entered mid-investigation as discipline, not resignation, and it stays reportable to national d…
Responding to a Board Subpoena for Patient Records
A stepwise guide to confirming scope, meeting the return date, and producing patient records to a state licensing board without in…
Supervising Nurse Practitioners and Physician Assistants in Multistate Telehealth
The patient's state, not the clinician's, generally sets the scope-of-practice and collaboration rules a multistate telehealth vis…
OIG Self-Disclosure Protocol: What a Submission Requires
What a complete OIG Self-Disclosure Protocol submission must contain, how damages are calculated, and what resolution brings once…
Moving to Dismiss an FCA Complaint Under Rule 9(b)
Why the first contested motion in a healthcare qui tam case turns on Rule 9(b) particularity, the circuit split, and what leave to…
Skin Substitute Application Coding: CPT 15271 Through 15278
CPT 15271 through 15278 split by anatomic site and measured wound area. A reviewer's first move is checking that split against the…
Hospital Outpatient Wound Center Billing: Facility and Physician Claims
One wound center visit produces two Medicare claims from the same chart, under different rules for documentation, supervision, and…