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Telemedicine and Cardiovascular Genetic Testing: What Do You Need to Know?

While telemedicine is gaining widespread acceptance – due in no small part to the impacts of the COVID-19 pandemic – when it comes to billing for telemedicine services, providers still face many challenges. Telemedicine billings often face enhanced scrutiny, and there are various issues that do not exist when providing...

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Cardiologist Defense: Cardiovascular Genetic Testing Fraud

For cardiologists, the introduction of cardiovascular genetic testing presents both new opportunities and new risks. Already, many cardiologists are facing scrutiny for Medicare billing fraud, and financial relationships with testing laboratories and other entities are leading to federal enforcement actions as well. As a cardiologist, anything you can use to...

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Department of Justice Renews Crack Down Fraudulent Billing and Unlawful Kickbacks

Healthcare professionals must ensure total compliance with Medicare, Medicaid, and other federally-funded government programs to avoid liability. Federal prosecutors are again focusing their efforts on preventing healthcare fraud. However, as prosecutors hone in on reducing fraud, law-abiding healthcare professionals may get caught in the government's wide net. Two of the...

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President Trump Issues Executive Order in Final Days of Presidency, “Protecting Americans From Overcriminalization”

In his second-to-last day as President of the United State, Donald Trump signed an executive order intended to limit the government's ability to criminally prosecute those in violation of certain regulations. The thrust of the Executive Order is to clarify when a violation of a regulation may result in criminal...

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Compliance Issues Related to Cardiopulmonary Exercise Testing

While Cardiopulmonary Exercise Testing is considered the gold standard of exercise testing, it is not appropriate for all patients. Over recent decades, advancements in medicine and technology have extended the expected lifespan. However, while newly available medical testing can help to diagnose serious health conditions, practitioners must be careful when...

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Physician’s Group Settles Medicaid False Billing Claim Related to Sleep Studies

A whistleblower complaint triggered the investigation, resulting in a $1.2 million settlement. Last year, Millennium Physicians Association, PLLC, paid the United States government $1,248,964 to settle a false billing claim related to allegations that the company billed Medicare for studies that were conducted without certified specialists. The case highlights how...

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After Major Takedown, DOJ Continues to Target Cardiovascular Genetic Testing Fraud

As cardiovascular genetic testing continues to garner widespread use, the DOJ is targeting health care providers that fraudulently bill for predictive testing and preventative services. In September 2019, the U.S. Department of Justice (DOJ) announced a major takedown involving doctors, testing laboratories, and telemarketing companies accused of fraudulently billing Medicare...

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Cardiovascular Genetic Testing Compliance: What Do Doctors Need to Know?

Cardiovascular genetic testing is a rapidly-growing, and extremely valuable, area of modern medicine. Providers seeking to offer these services to their patients must prioritize billing compliance in order to avoid recoupments, pre-payment review, and other penalties for health care fraud. For health care providers that offer cardiovascular genetic testing (hereditary...

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What Doctors Need to Know Before Billing for Cardiovascular Genetic Testing

When billing Medicare and other payors for cardiovascular genetic testing, a key issue is whether the testing is "medically necessary" under the applicable billing guidelines. Cardiovascular genetic testing is a breakthrough form of diagnostic screening that allows doctors to help patients plan for – if not prevent – potentially-serious health...

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What are the FBAR Penalties if You Don’t File with FinCEN?

If you are required to file an annual FBAR form with the U.S. Treasury Department's Financial Crimes Enforcement Network (FinCEN), failing to file can lead to steep penalties. Filing an inaccurate FBAR can have severe consequences as well. This is true even if your failure to file or the inaccuracy...

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