Legal Insights

In the article we outline the basics of RPM billing and coding, including which RPM services are billable by payor, the unique fraud risks associated with RPM, and best practices for providers to ensure their billing/coding procedures for RPM services are legally compliant.

Express Scripts is using aggressive audits and investigations to recoup the dollar value of test claims that were never paid. Don't let ESI intimidate you—contact us today for effective audit defense.

Learn how to obtain and protect your DEA registration with our step-by-step guide, updated for 2025 telehealth rules and audit trends—plus proven strategies to resolve denials and maintain compliance. Designed for healthcare providers by legal experts specializing in regulatory defense.

Explore the complexities and barriers telehealth providers face when offering services across state lines. This article will provide expert guidance on managing licensing requirements, navigating compacts, and understanding the legal limitations of interstate telehealth.

PBM audits extend beyond paperwork, assessing pharmacy operations, staff preparedness, SOPs, and compliance culture. Proactive strategies, training, and legal expertise ensure audit readiness.

Navigate 2025 PBM audits confidently: Key triggers, trends, and preparation tips to protect your pharmacy.

Dive deep into the documentation side of audits. PBMs often demand a mountain of paperwork, and missteps here can trigger penalties.

How technology can transform audit readiness, making compliance less stressful.

Address the increasing scrutiny telehealth providers face regarding potential fraud, waste, and abuse in virtual care. This article delivers expert insights into structuring telehealth practices to avoid fraud allegations, including strategies for compliance with the Anti-Kickback Statute, Stark Law, and other relevant regulations.