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 40
Page 40 of 114 · 1029 articles
Escalating a Medicare Appeal After a Missed Decision Deadline
What happens when a QIC or ALJ misses its own Medicare appeal deadline, how a provider requests escalation, and what escalating ac…
Telehealth Prescribing Volume as an Audit Trigger
Medicare's UPIC and MEDIC analytics flag telehealth prescribers on volume alone. What triggers the flag, and how to defend a high-…
Telehealth Practice Acquisitions and Regulatory Diligence
What buyers inherit in a telehealth acquisition: licensure gaps, platform-contract terms, and billing exposure that transfers with…
Corrective Action Plans After a Medicaid Audit
What a state Medicaid agency expects in a corrective action plan after an audit finding, who signs it, the follow-up review, and t…
DEA Diversion Investigator Interviews: What Staff Should Know
What DEA diversion investigators ask pharmacy staff, whether the interview is voluntary, and why counsel for the pharmacy is not a…
DEA Accountability Audits: Challenging a Shortage Finding
How a DEA accountability audit turns purchases, dispensing records and two counts into a shortage finding, and the assumptions a r…
503B Reporting Obligations After Registration
The recurring FDA duties a 503B outsourcing facility carries after registration: the biannual product report, annual renewal, and…
Telehealth Place of Service Coding Errors
POS 02 and POS 10 decide which of two Medicare rates a telehealth claim is paid at, and auditors have a documented method for catc…
Change of Ownership in Medicaid: Disclosure and Successor Liability
Buying or selling a Medicaid-enrolled provider means updating ownership disclosures, checking the seller's open audits and overpay…