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 46
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Wound Care Practice Acquisitions and Audit Liability
A wound care acquisition can inherit the seller's audit exposure. What diligence should uncover, and how the 60-day overpayment cl…
Telemarketing-Driven Healthcare Fraud Schemes
How telemarketing and telehealth lead-generation schemes work, the DOJ takedowns built on them, and how a legitimate physician's e…
When a Wound Care Audit Becomes an FCA Case
The civil investigative demand, payment suspension, and extrapolated demand signals that mark when a wound care Medicare audit bec…
Under Seal: What Happens Before You Know You Are Sued
A qui tam seal can run for years while the government investigates. Here is what 31 U.S.C. Section 3730(b) requires and how provid…
Self-Auditing Wound Care Claims Before the Payer Does
How to sample your own wound care charts, quantify extrapolated exposure, and decide between the 60-day refund rule and OIG self-d…
Signing Orders From a Telehealth Platform: Your Exposure
Chart review adequacy, patient contact, and the DME and lab order pipeline determine whether a signed telehealth order becomes a f…
RPM Device Supply and Kickback Questions
Free or below-cost RPM devices from vendors can trigger Anti-Kickback Statute and beneficiary inducement exposure for telehealth p…
Multi-State Licensure After Discipline in One State
A board action in one state can trigger automatic suspension, NPDB reporting, and renewal disclosure duties everywhere else a phys…
Target Letters: Reading Yours Accurately
A DOJ target letter signals substantial evidence, not an indictment. What target status means, the window it opens, and the respon…