If you are negotiating a Corporate Integrity Agreement (CIA) on behalf of a client, you may need the services of an Independent Review Organization (IRO) to manage the ensuing work and make sure that you make the right business choices. All IROs are not created equally. So, what do you need to know to select the IRO best suited to the situation? But what exactly is an IRO, and why is it so important? LW…
The regulatory landscape for Medicare overpayments is evolving rapidly, and the risks for healthcare providers are growing — especially when it comes to repayments and potential liability under the False Claims Act (FCA). Our latest whitepaper, “Voluntary Medicare Extrapolated Overpayments: Legal and Compliance Considerations in 2025”, sheds light on what healthcare attorneys can do to guide their clients. Key Takeaways Why This Matters Providers across the continuum are under significant pressure—regulatory, legal, and operational. If…
The Centers for Medicare & Medicaid Services’ (CMS) 2025 Targeted Probe and Educate (TPE) audits continue to reveal the same issues—missing medical necessity details and incomplete plans of care. These gaps put therapy practices at risk of denials and penalties. Therefore, internal auditing is essential to ensure compliance and audit readiness. As payers and regulators increase scrutiny, documentation and billing are no longer just administrative tasks; they are crucial to reimbursement and long-term sustainability. Internal…
Sign up today to receive our complimentary newsletter, Guidance on Compliance, with the latest healthcare compliance and risk management information.