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Seven Things To Know When You Receive A Notice Of Investigation From The Department Of Health

Health Law Update February 2009


February 17, 2009

1. Department of Health (DOH) Investigations:

— “Medical Malpractice Investigator” or “Medical Quality Assurance Investigator”

— “Uniform Complaint” is now called “Case Summary”

— “Priority 1”

— “25 Biggest Mistakes Physicians Make in DOH Investigations

2. Medicare Audits by the Centers for Medicare & Medicaid Services (CMS), First Coast Service Options, Inc. (FCSO), and others:

— Recovery Audit Contractors (“RAC” Audits)

— “Place of Service” Audit Letters

3. “Disruptive Physician”

— JCAHO “Alert” and renewed emphasis on eliminating “disruptive physicians”

— Professionals Resources Network (PRN) and the
   “Physicians Development Program” and “P.U.L.S.E.”

— Responding to Peer Review Requests