NM Talks Healthcare

Navigating Medicare and Medicaid Regulatory Audits The Devil You Know

18 min · 14. kesä 2024
jakson Navigating Medicare and Medicaid Regulatory Audits The Devil You Know kansikuva

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In this episode, Nelson Mullins partner Knicole Emanuel and senior associate Melissa Scott analyze the framework of Medicare and Medicaid regulatory audits of healthcare providers by shedding light on the relationship between the Medicare and Medicaid Integrity Programs and the types of contractors driving the force of compliance investigations. Emanuel and Scott also provide an overview of the audit process and strategies for providers to manage compliance-related risks and defend against unfavorable audit decisions.

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jakson Elevate your Management Services Organization with a Value-Based Enterprise kansikuva

Elevate your Management Services Organization with a Value-Based Enterprise

On this episode of NM Talks Healthcare, Nelson Mullins partners Ed White and Mike Segal are joined by Jim Carr and Luis Argueso, consultants, partners, and co-founders of InHealth Advisors. During the episode, they discuss the concept of how a Value-Based Enterprise (“VBE”) can transform the relationship between a management services organization (“MSO”) and its friendly physician professional corporation (“PC”), how to integrate a VBE into the MSO-friendly PC structure to help change the narrative surrounding non-physician participation in healthcare delivery, how a VBE can create a low-risk regulatory environment in the MSO-friendly PC structure, how new VBE revenue generation opportunities can enable an MSO to improve alignment with its physician providers and lessen reliance on restrictive covenants, and how creating new collaborative opportunities can lessen dependence on acquiring physician practices and open possibilities for partnering with hospitals.

13. touko 202448 min