Oberheiden, P.C. Blog

The Growing Threat of Zone Program Integrity Contractor (ZPIC) Audits

Categories: Health Care Law

Health care providers face immense scrutiny for allegations of fraud and abuse in the current regulatory climate. Consequently, they encounter significant threats to their future business viability, including recoupment and civil/criminal penalties, when undergoing audits conducted by the federal government. It is essential that you as a healthcare provider, servicing the Medicare market, fully understand…

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Hyperbaric Oxygen Therapy Fraud Investigations

Categories: Health Care Fraud

medicare fraud

Federal Prosecutors Have Raided Medicaid and Medicare Providers for Alleged Fraud in Connection with Oxygen Therapy Devices Medicare and Medicaid reimburse well for hyperbaric oxygen therapy devices and several business owners and providers have promoted the idea to beneficiaries. Unfortunately, however, the dispensing of oxygen devices is a decision of medical necessity that requires the…

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What Cardiologists Should Know About Medicare Fraud Prosecutions

Categories: Health Care Law

medicare fraud investigations

CMS & FBI Targets Cardiologists for Stress Tests, Opioid Abuse, and Billing Fraud. Prosecutions Nationwide. Are you a cardiologist? Is your business under audit? Did a patient threaten to complain against you? Did you receive a ZPIC audit request? Are you consider an “outlier?” Have you received notice from the government that your clinic is…

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When Can a Mobile Ambulance Ride Lead to Charges for Medicare Fraud?

Categories: Health Care Law

Mobile Ambulance

Medicare’s Strict Billing Rules for Mobile Ambulance Services Create Significant Risks for EMS Providers Emergency medical services (EMS) providers serve a critical role in our health care system. However, like all health care providers that bill Medicare for their services, they are subject to strict billing rules and regulations, and failure to adhere to these…

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How Can I Avoid Criminal Charges in a Medicaid Fraud Audit?

Categories: Health Care Law

medicaid audit gavel and money

The Current Reality of Medicaid Enforcement Did your practice receive a request for patient charts? Are you under audit? Did a Medicaid intermediary send you a letter or did investigators from the Medicaid Fraud Control Unit tried to interview you? Are you concerned you could be under Medicaid investigation? If so, this is what you…

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