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 49
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Interstate Telehealth Licensure and Enforcement Risk
Interstate telehealth licensure turns on where the patient sits. What compacts cover, what they don't, and the criminal and billin…
Impaired Practitioner Programs: Terms and Tradeoffs
What monitoring agreements actually require, why five years is the standard term, and the tradeoffs behind choosing an alternative…
UPIC Record Requests: How Many Charts Is Normal
A UPIC records request for ten claims signals a probe. Thirty or more usually means the contractor is building toward extrapolatio…
The FCA Statute of Limitations and the Tolling Fight
The False Claims Act runs on two limitations clocks. Cochise Consultancy settled which one controls when the government declines t…
What a UPIC Audit Costs Even When You Win
Prepayment review, professional fees, and lost time build up over a UPIC audit's full timeline, whether or not the provider is ult…
Documenting Patient Consent for Telehealth
Telehealth consent has to be documented per visit, not just at intake, or a payor or UPIC audit can treat the whole encounter as u…
DTC Telehealth Models and Federal Enforcement
Advertising-driven telehealth models face DOJ and HHS-OIG enforcement over volume-based prescriber pay and independent medical jud…
Pretrial Diversion for First-Time Healthcare Offenders
Pretrial diversion can dismiss a federal healthcare fraud charge, but state licensing boards often treat the agreement itself as r…
Proffer Sessions in Healthcare Fraud Cases
A proffer session lets a physician give investigators an account under a proffer agreement, but the protection it provides is narr…