Insights & Analysis
Practical guidance on PBM audits, federal investigations, compounding defense, DEA enforcement, telehealth compliance, and the regulatory pressures facing pharmacies and providers nationwide.
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Provider Relief Fund Audits and Enforcement
How HRSA's attestation deadlines, lost revenue methodology, and Single Audit threshold create Provider Relief Fund audit exposure…
License Discipline and Medicare Enrollment Consequences
How a state board's license suspension or revocation can independently trigger Medicare enrollment revocation and a separate OIG e…
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…