The U.S. Environmental Protection Agency (EPA) expects companies to self-police their environmental compliance efforts. While the EPA regularly conducts inspections focused on assessing environmental compliance, it also...more
8/21/2024
/ Audits ,
CERCLA ,
Clean Water Act ,
Compliance ,
Compliance Monitoring ,
Environmental Policies ,
Environmental Protection Agency (EPA) ,
Environmental Violations ,
EPCRA ,
FIFRA ,
RCRA ,
Risk Assessment ,
Risk Mitigation ,
Safe Drinking Water Act ,
Toxic Substances Control Act (TSCA)
A Qlarant audit is a serious event in the life of a healthcare provider and company. This auditing contractor claims that it is a non-profit company that works on behalf of the government to uncover healthcare fraud and...more
Medicare, Medicaid, and pharmacy benefit manager (PBM) audits can result in substantial losses for pharmacies. If auditors uncover evidence—or apparent evidence—of overpayments, not only can they initiate recoupments, but...more
Medical professionals, patients, and others can commit healthcare fraud by deceiving the healthcare system, such as providing medically unnecessary services, in order to get unauthorized benefits or payments. Facing...more
If you are a healthcare provider, you are bound to get audited at some point. Who conducts that audit (this includes federal authorities such as the Department of Health and Human Services (HHS), the Center for Medicare and...more
An audit by the Food and Drug Administration (FDA) can uncover violations of federal food and drug regulations, as well as the Food, Drug, and Cosmetic Act (FD&C Act). Those violations can lead to administrative, civil, or...more
Pharmacy benefit manager (PBM) audits are becoming increasingly dangerous for pharmacies. While the role of the PBM was initially to reduce costs for all parties involved, abusive PBM practices have led to the opposite in...more
In many ways, the COVID-19 pandemic increased the business opportunities available to clinical labs, including molecular and respiratory labs. As the nation—and the world—struggled to develop adequate testing infrastructure,...more
1/19/2022
/ Audits ,
Clinical Laboratories ,
Coronavirus/COVID-19 ,
Defense Strategies ,
Department of Health and Human Services (HHS) ,
FBI ,
Health Care Providers ,
Healthcare Fraud ,
Investigations ,
Medical Billing Codes ,
Medical Necessity ,
OIG ,
Patient Referrals ,
Physicians
The Food and Drug Administration is the federal agency charged with ensuring the safety of food, medication and other consumable products. In carrying out its duties, the FDA conducts both inspections of plants and...more
Cardiovascular stress testing to diagnose patients with coronary artery disease (CAD) and other related types of conditions can be a highly-effective tool in many cases. In fact, many cardiologists routinely recommend stress...more
8/24/2021
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Documentation ,
False Billing ,
Health Care Providers ,
Investigations ,
Local Coverage Determinations (LCDs) ,
Medical Necessity ,
Medicare ,
Medicare Fraud ,
OIG ,
Policies and Procedures ,
Stress Tests
Durable medical equipment (DME) is particularly important for many Medicare beneficiaries. However, companies that manufacture and sell DME need to be careful because there are strict federal regulations outlining almost...more
7/28/2021
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Chief Compliance Officers ,
Civil Liability ,
Compliance ,
Compliance Commitees ,
Corrective Action Plans (CAPs) ,
Criminal Liability ,
Department of Health and Human Services (HHS) ,
Disciplinary Proceedings ,
Durable Medical Equipment ,
Employee Training ,
Health Care Providers ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
OIG ,
Physicians ,
Policies and Procedures ,
Standard of Conduct ,
TRICARE
Purpose and Background of the GLBA -
The Gramm-Leach-Bliley Act (“GLBA”), also known as the Financial Services Modernization Act of 1999, is a federal statute enacted by Congress in 1999 that requires financial...more
7/20/2021
/ Auditors ,
Audits ,
Banking Sector ,
Best Practices ,
Compliance ,
Customer Information ,
Data Breach ,
Data Privacy ,
Data Security ,
Financial Institutions ,
Financial Services Industry ,
GLBA Privacy ,
Gramm-Leach-Blilely Act ,
Incident Response Plans ,
Non-Public Information ,
Personal Information ,
Privacy Rule ,
Risk Assessment ,
Safeguards Rule
Zone Program Integrity Contractors (ZPICs) are federal contractors that work under the direction of the Centers for Medicare and Medicaid Services (CMS) to uncover fraudulent billings under Medicare. ZPICs have broad...more
5/25/2021
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Defense Strategies ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
Health Care Providers ,
Healthcare Fraud ,
Medicare ,
Overpayment ,
Provider Payments ,
Underpayment ,
Zone Program Integrity Contractors (ZPICs)
Compliance is a top legal concern for companies in all industries. From adequately protecting customer and employee data to avoiding allegations of bribery and fraud, compliance can mean different things under different...more
While there has been a lot of controversy in the media surrounding the Paycheck Protection Program (PPP), there is no question that the program has served as an invaluable lifeline to many small and medium-sized businesses...more
7/16/2020
/ Audits ,
Bank Fraud ,
Business Ownership ,
CARES Act ,
Civil Liability ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Government Investigations ,
IRS ,
Paycheck Protection Program (PPP) ,
Penalties ,
SBA ,
Small Business Loans ,
Tax Evasion ,
Treble Damages ,
Wire Fraud