The Texas Medical Board (TMB) is warning physicians and pharmacies of a scam involving criminals who sometimes pose as TMB officials. TMB passed along a report from the U.S. Drug Enforcement Administration (DEA) that says physicians registered with the DEA are receiving calls and emails from criminals who identify themselves as DEA personnel or other law enforcement agents.

Who Will Run Your Practice If You Can’t? - 08/23/2023

You might have given thought to what would happen to your solo practice and your family in the event of your death, but what if you have a serious accident or illness and are unable to work for, say, several months?

Top Three Reasons Embezzlement Occurs - 10/11/2022

Medical practices suffer from one of the highest embezzlement rates of all service industries.Several factors can contribute to embezzlement. The top three are opportunity, pressure, and rationalization.

Did That Employee Quit, or Did You Fire Her? - 10/11/2022

The question of whether an employee quit or was fired is very important if the ex-employee files for unemployment benefits. It determines who has the burden of proof in the case. These tips from the Texas Workforce Commission can help you keep the onus of proof off you.

How to Delete Data — for Real - 10/07/2022

Whenever your practice scraps, trades in, donates, or sells electronic equipment, make sure the storage media is wiped clean of all data. Often your safest bet to remove the storage capabilities and destroy the hard drives or memory cards.

New Patient Visit: Three Years Is a Key - 12/03/2021

Centers for Medicare & Medicaid Services auditors have identified claims coded for “new patient” evaluation and management services that don’t fit the definition for new patient services. Be sure to avoid this coding error.

Paying Employees for Lunch Break - 09/08/2021

Does your practice have clear policies regarding rest and meal breaks for hourly (nonexempt) employees?

Data Driven: Medicaid’s Inspector General Focuses on Fraud Prevention, Not Just Prosecution - 09/06/2021

Since her appointment in 2018, Texas Health and Human Services Inspector General Sylvia Hernandez Kauffman has homed in on using data analytics not only to prosecute fraud, waste, and abuse within the Medicaid program, but also to prevent it from happening in the first place. Texas Medicine spoke to Ms. Kauffman about what appears to be a shift in tone from this department as it also focuses on using the data it collects to educate physicians and other health care professionals on common billing mistakes.

How to Respond to a Medicare Audit - 08/27/2021

TMA Practice E-Tips editors ran across this excellent checklist of “17 tips from a lawyer” on how to respond to a Medicare audit.

Why, What, and Who Keys to Recoupment-Proof Documentation - 03/30/2021

The lack of a signature on specific portions of an otherwise complete documentation is enough to warrant a Medicare payment recoupment. Here’s what the Centers for Medicare & Medicaid Services found in three Comprehensive Error Rate Testing reviews.

Can’t Say It Enough: Document, Document, Document - 08/11/2020

When Medicare delves into claims errors, one stands out: insufficient documentation.

HIPAA: Are You Prepared for a Lost Laptop or Smartphone? - 05/30/2019

Even if the only work-related activity is accessing your email, you may have PHI on your phone right now. Lost and stolen devices are the No. 1 reason for patient data breaches of more than 500 records.

HIPAA: Are You Prepared for a Business Associate Breach? - 05/30/2019

Business associate breaches can be the most costly type of breach and present some of the highest risk because you don't have insight or control over the business associate's security or policies.

EHR Vendors Behaving Badly; What Can You Do? - 08/27/2018

Have you had a problem with your electronic health record vendor not following through on its contractual obligations? Many practices don’t know how or where to get help.

Your EHR Is Watching You - 10/31/2017

Document, document, document. This is the mantra you follow carefully in creating your medical records. Bear in mind, though: Your electronic medical record is doing some documenting of its own.

CMS to Expand Audits, Education Targeted to Outliers - 09/13/2017

A new type of audit may be coming your way, as the Centers for Medicare & Medicaid Services puts a pilot claims review program into practice nationwide.

Fraud, Waste, and Abuse Training: Not Just for Medicare Advantage Plans - 01/27/2017

Medicare requires annual fraud, waste, and abuse training for physicians contracted with any Medicare Advantage plan and their staff. But all practices should provide this type of training to all employees, regardless of health plan participation, says TMA.

Nine Do’s and Don’ts for Enforcing Office Policies - 12/07/2016

Having office policies is one thing. Enforcing them fairly and consistently is another. By failing to do the latter, you risk losing unemployment claims.

Follow-Up Failures Are Risky - 12/06/2016

Missed appointments and failures to follow up pose some of the greatest legal risks for physicians. Here are some risk-management tips for your practice.

How to Apologize Like You Mean It - 11/15/2016

Everybody makes mistakes. Physicians — even the best, most well-intentioned ones — make mistakes. Regardless of the nature of the mistake, you must take steps to correct it, and that includes apologizing. But it’s important to do it right, or you may make matters worse.

Identify Your Own Fraud and Abuse Red Flags - 09/26/2016

One way to help keep your practice operations squeaky clean and in compliance with fraud and abuse laws is to develop an internal set of warning indicators.

Use Correct Surgery Modifiers in Medicare Claims - 05/13/2016

Medicare auditors working under the Recovery Audit program have identified significant payment errors related to surgery. Be sure to bill correctly using these modifiers.

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