Category Archives: Reimbursement & Payment Practices

Medicare Opt-Out – A Make-or-Break Decision for Concierge Physicians

For physicians moving into concierge, direct-pay, or cash-based practice models, opting out of Medicare is a consequential compliance decision—not merely an administrative formality. A properly executed Medicare opt-out changes how the physician may treat and bill Medicare beneficiaries, how private … Continue reading

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Podcast – ASC 2030: The New Playbook

Episode 17 – ASC 2030: The New Playbook Welcome to “ASC 2030: The New Playbook,” the seventeenth episode in our Legal Pulse: Healthcare Edition series. In this episode, we’ll take a forward-looking approach and explore what the next decade holds … Continue reading

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Podcast – ASC Life Safety Code Decoded

Episode 16 – ASC Life Safety Code Decoded Welcome to “ASC Life Safety Code Decoded,” the sixteenth episode in our Legal Pulse: Healthcare Edition series. In this episode, we break down the life safety requirements that Ambulatory Surgery Centers must … Continue reading

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Podcast – ASC Survey Ready Now

Episode 15 – ASC Survey Ready Now Welcome to “ASC Survey Ready Now,” the fifteenth episode in our Legal Pulse: Healthcare Edition series. Today’s discussion centers on preparing your Ambulatory Surgery Center for regulatory surveys and inspections. ASC Survey Ready … Continue reading

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Podcast – ASC Coverage Rules Decoded

Legal Pulse: Healthcare Edition Welcome to Legal Pulse: Healthcare Edition, the podcast where we explore the intersection of law and medicine to keep you informed on the latest developments and trends. Episode 11 – ASC Coverage Rules Decoded Welcome to … Continue reading

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Wisconsin Medicaid Telehealth Reimbursement: What Providers Need to Know

Wisconsin Medicaid Telehealth Reimbursement – Wisconsin Medicaid allows many covered services to be delivered by telehealth when the service is clinically appropriate and functionally equivalent to in-person care. This article by Wisconsin telehealth lawyer John Fisher explains how ForwardHealth reimbursement … Continue reading

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Podcast – Medicare’s Code Revolution 2026

Legal Pulse: Healthcare Edition Welcome to Legal Pulse: Healthcare Edition, the podcast where we explore the intersection of law and medicine to keep you informed on the latest developments and trends. Epidoe 10 – Medicare’s Code Revolution 2026 Welcome to … Continue reading

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Annual Health Care Fraud and Abuse Control Program Report

 2026 Health Care Fraud Enforcement Update: Compliance Risks, False Claims Act, and Medicare Advantage Health care fraud enforcement is no longer a distant risk reserved for bad actors on the margins of the industry. In 2026, health care providers, suppliers, … Continue reading

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Key Elements for Medical Practice Policies: Incident-to Billing, Physician Supervision, and False Claims Act Enforcement Risk

Understanding Compliance Requirements for Healthcare Providers Medical practices face a complex landscape of billing and compliance regulations. Three critical areas—Incident-to Billing, Physician Supervision, and False Claims Act Enforcement Risk—demand careful attention when crafting practice policies. Establishing clear guidelines not only … Continue reading

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Podcast – ASC Compliance 2026 – Complying With the New Regulations

Legal Pulse: Healthcare Edition Welcome to Legal Pulse: Healthcare Edition, the podcast where we explore the intersection of law and medicine to keep you informed on the latest developments and trends. Episode 7 – ASC Compliance 2026 Welcome to “ASC … Continue reading

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