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 33
Page 33 of 113 · 1018 articles
Board Disciplinary Hearings: Procedure, Evidence, and Witnesses
Board disciplinary hearings test the burden of proof, the investigative file, and the standard-of-care witness, and procedure diff…
Clinical Staff Time and Supervision in Remote Patient Monitoring
CMS lets contracted clinical staff furnish RPM time under general supervision now, but a 2027 proposal and active OIG audits are t…
Claims Billed Under Your NPI by a Telehealth Company
A telehealth company can bill Medicare under a physician's NPI through reassigned billing rights, but the physician, not the platf…
UPIC Requests for EHR Access, Audit Trails, and Metadata
When a UPIC asks for EHR access, an audit trail, or chart metadata, scope and production choices shape what the reviewer finds and…
UPIC Reopenings: How Far Back Paid Claims Can Be Reviewed
A UPIC reopening of a paid claim runs on the 42 C.F.R. 405.980 standard, not a fixed lookback number, and it is not the sample per…
Backdating and Late Chart Edits in a Federal Investigation
A federal healthcare fraud investigation changes the legal stakes of any chart correction. The line between a proper late entry an…
UPIC Records Requests Versus OIG Subpoenas: What Compels Production
A UPIC records request and an HHS-OIG subpoena rest on different legal authority and carry different consequences for non-producti…
Billing an Office Visit on the Same Day as Debridement
Modifier 25 lets an E/M office visit and a debridement procedure pay on the same date, but only when the visit documents work the…
Advance Beneficiary Notices for Non-Covered Wound Care Services
What a wound care ABN must state before a skin substitute or debridement claim Medicare may deny, and why a missing or invalid not…