Counsel to a healthcare provider network sought help from our Forensic Services Practice to review post-enrollment billing practices for newly credentialed counselors. Although these clinicians were appropriately licensed, our team conducted forensic analysis revealing that the relevant documentation didn’t consistently demonstrate required supervisory oversight—potentially undermining claim validity. We advised the client on efficient ways to successfully resolve the financial exposure and identified ways in which they could strengthen documentation protocols and reinforce payer-specific supervision standards to protect future claims.
DOJ declinations show the value of early voluntary disclosure
US Department of Justice (DOJ) declinations involving Robert Bosch GmbH (Bosch) and Campus Eye Management Holdings LLC (Campus Eye) offer early insight into...