Disclaimer

All content on this website — including service descriptions, blog posts, resource guides, compliance guides, newsletters, email communications, deliverable reports, and any other materials produced or distributed by Prognosis Consulting — is provided for general informational and educational purposes only. Nothing on this website or in any Prognosis Consulting deliverable constitutes legal advice, and no attorney-client relationship is formed by accessing this website, engaging our services, or receiving any deliverable from us.

Regulatory compliance in healthcare is fact-specific. The application of any federal or state regulation, CMS policy, MAC local coverage determination, or OIG guidance to a particular organization's circumstances requires legal analysis that this firm is not qualified to provide and does not provide. If you have a question that requires a legal opinion — including questions about False Claims Act exposure, Stark Law, Anti-Kickback Statute, voluntary self-disclosure, OIG advisory opinion eligibility, or any enforcement or litigation matter — consult a qualified healthcare attorney.

Prognosis Consulting (a d/b/a of Sundwyn Group LLC) is not a law firm and is not licensed to practice law in Georgia or any other jurisdiction. No attorney employed by or affiliated with this firm provides legal services through Prognosis Consulting. Our services are compliance advisory and revenue cycle consulting services — distinct from the practice of law.

Where our work involves reviewing regulatory citations, summarizing OIG guidance, or drafting corrective action language, that work is provided as compliance advisory material and not as legal analysis. We regularly work in coordination with healthcare attorneys on client engagements and recommend that clients retain legal counsel on any matter with enforcement, litigation, or contractual implications.

Prognosis Consulting provides healthcare compliance advisory and revenue cycle consulting services including, but not limited to: coding and documentation audits, LEIE exclusion screening, OIG Work Plan readiness analysis, hospice compliance assessments, and written compliance deliverables.

Our deliverables — including findings reports, compliance certificates, audit memos, corrective action registers, cap liability projections, and resource guides — represent our professional assessment of the materials reviewed and our understanding of applicable regulatory standards as of the date of the deliverable. They do not constitute a guarantee of compliance, a guarantee of audit defense outcomes, a guarantee of payment or reimbursement, or a legal opinion on any matter.

Clients are responsible for implementing corrective actions identified in our deliverables, for maintaining their own compliance programs, and for seeking legal counsel where appropriate. Our engagement does not transfer compliance responsibility from the client organization to Prognosis Consulting.

Prognosis Consulting makes no representation or warranty that use of our services will prevent audits, recoupment demands, or enforcement actions; that ADR or TPE responses prepared with our assistance will result in favorable determinations; or that any hospice, practice, or agency implementing our recommendations will achieve full regulatory compliance.

Medicare and Medicaid payment integrity programs are administered by CMS, the OIG, MAC contractors, and state agencies whose determinations are independent of our assessments. Our deliverables represent our professional judgment based on the information available to us at the time of the engagement. They do not predict or guarantee the outcome of any audit, appeal, or enforcement proceeding.

Healthcare regulation changes continuously. CMS issues final rules, proposed rules, transmittals, and program memoranda throughout the year. The OIG updates its Work Plan on a rolling basis. MACs issue and revise Local Coverage Determinations and Billing and Coding Articles. State agencies issue guidance specific to their jurisdictions.

Content on this website and in our resource guides is current as of the dates indicated. We make reasonable efforts to keep published materials current but do not guarantee that any particular piece of content reflects the most current regulatory position at the time of your access. For compliance decisions, always verify the current regulatory standard directly from the authoritative source — the Code of Federal Regulations, CMS.gov, OIG.HHS.gov, and the relevant MAC's website.

Deliverables produced in the context of a paid engagement reflect the regulatory environment as of the engagement date. Organizations are responsible for monitoring regulatory changes after delivery and updating their compliance programs accordingly.

Our LEIE exclusion screening service screens submitted roster data against the OIG List of Excluded Individuals and Entities as maintained and published by the OIG. The accuracy of our screening results depends on: (a) the accuracy and completeness of the roster data submitted by the client; (b) the completeness of the OIG LEIE dataset at the time of the screening; and (c) the limitations inherent in name-matching, phonetic matching, and fuzzy logic algorithms applied to an imperfect underlying dataset.

A clean screening result — a finding of no match — does not constitute a guarantee that a provider is not excluded. The OIG LEIE may contain data entry errors, may not reflect real-time exclusion actions, and the matching algorithms we apply may not detect every possible name variant or alias. Clients are advised to independently verify exclusion status for high-risk providers and to implement a documented, multi-source exclusion screening program as part of a broader compliance program.

Prognosis Consulting is not responsible for inaccuracies in the OIG LEIE dataset, for exclusions that are not reflected in the LEIE at the time of screening, or for false negative results caused by data discrepancies between the client's roster and the LEIE source data. Our screening certificates document the methodology applied and are issued based on the information available at the time of screening.

OIG Work Plan compliance guides and other downloadable resources sold through our Gumroad store are provided for informational and educational purposes. They are professional reference documents, not legal opinions or compliance certifications. Purchase of a guide does not constitute a compliance engagement and does not establish a consulting relationship with Prognosis Consulting.

The guides reflect our interpretation of publicly available OIG Work Plan materials, CMS regulations, and MAC guidance as of the dates indicated in each guide. We make reasonable efforts to ensure accuracy but do not warrant that the guides are free from error or that they reflect the most current regulatory position at the time of your access or use.

All sales of digital products are final. Refund requests are evaluated on a case-by-case basis.

This website and our deliverables may reference or link to third-party websites, regulatory publications, MAC contractor pages, CMS resources, and OIG publications. These links are provided for reference and informational convenience only. Prognosis Consulting does not endorse, control, or assume responsibility for the accuracy, completeness, or currency of third-party content. Links to government resources — CMS.gov, OIG.HHS.gov, Palmetto GBA — are provided for direct verification of regulatory standards and do not imply any affiliation with or endorsement by those agencies.

To the maximum extent permitted by applicable law, Sundwyn Group LLC d/b/a Prognosis Consulting, its principals, employees, and contractors shall not be liable for any direct, indirect, incidental, consequential, or punitive damages arising out of or related to your use of this website, any content published on this website, any deliverable produced under a consulting engagement, or any digital product purchased through our store.

Our aggregate liability for any claim arising from a consulting engagement shall not exceed the total fees paid for the specific engagement giving rise to the claim. This limitation applies to all claims whether based in contract, tort, negligence, strict liability, or any other legal theory.

Some jurisdictions do not allow the exclusion or limitation of certain damages. In such jurisdictions, our liability shall be limited to the maximum extent permitted by applicable law.

If you have questions about this disclaimer, the scope of our services, or the limitations described here, contact us directly:

Sundwyn Group LLC d/b/a Prognosis Consulting
Email: hello@prognosisconsulting.com
Website: prognosisconsulting.com

This disclaimer was last updated in May 2026. We reserve the right to update this disclaimer at any time. Material changes will be reflected in the "Last updated" date above.