Firm News / Press Releases

According to some estimates, Medicare spends more than $12 billion a year in expenses associated with potentially avoidable readmissions.  This article discusses techniques hospitals can use to develop an effective plan to prevent Medicare readmission penalties.

The 2012 Office of Inspector General (OIG) Work Plan offers providers a helpful overview of Medicare enforcement priorities.  With respect to skilled nursing facilities (nursing homes or “SNF’s), the Work Plan contains five “carryovers” from 2011 and three new areas of inquiry.  The plan is a helpful guide of priority areas in need of improvement and those coming under imminent scrutiny.  In general, the common theme is monitoring quality of care while simultaneously cracking down on fraud and abuse.

Benjamin Fenton successfully defended a High Desert podiatrist against accusations by the Board of Podiatric Medicine.

This article provides an overview of the recent lawsuit filed by Aetna against Bay Area Surgical Management LLC, alleging the surgery centers illegally induced its physician investors to refer their patients to the surgery centers with promises that the patients would not have any financial responsibility to the surgery centers for their out-of-network coinsurance and deductibles. 

This is a hot topic for ASC’s as they should be concerned that health insurers might use aggressive litigation tactics to challenge any type of discount arrangement that the insurer does not like, even if it is designed simply to avoid the unsavory process of sending patients to collections.

Healthcare fraud risks in medical transport services has been receiving increasing attention from regulators.

With the holiday season in full swing, physicians in California need to understand the potential consequences of driving while intoxicated.

Physicians Need to Get Ready for the Overhaul of the Diagnostic Coding System

Getting prepared for the upcoming standards in electronic transmission of health information

“Giant Step” Towards Transparency Raises Physician Concerns

Harry Nelson quoted in L.A. Business Journal