The ground beneath healthcare practice management is always shifting, and for podiatry practices, 2026 represents a critical compliance checkpoint. Beyond the ever-present challenge of maximizing clean claim submissions, practitioners must navigate a complex web of federal regulations designed to prevent fraud, protect patient data, and curb wasteful spending.

At JARALL Medical Management, we know that success isn’t just about revenue—it’s about defensible revenue. That’s why our service includes access to healthcare attorneys and compliance experts who work to shield your practice.

Here are five critical legal and compliance pitfalls your podiatry practice must prioritize avoiding in 2026.

1. Failure to Implement the New HIPAA Security and Privacy Overhauls

HIPAA is no longer a checklist; it’s a living security framework. The compliance landscape is facing significant changes, with deadlines looming in early 2026 that will dramatically impact how you handle patient data.

The Pitfall: Treating HIPAA as “Just an IT Issue”

Many practices view the Security Rule as solely the responsibility of their IT vendor. In 2026, this reactive approach will be a massive liability. Upcoming regulations are expected to mandate a stricter, proactive security posture, including:

  • Mandatory Multi-Factor Authentication (MFA): This is moving from a suggestion to a requirement for systems accessing Electronic Protected Health Information (ePHI).
  • Encryption of ePHI: Expect stricter requirements for encrypting patient data, both at rest (stored) and in transit (sent).
  • Updated Notices of Privacy Practices (NPPs): A key compliance deadline (expected February 2026) requires updating your NPPs to reflect new patient rights, particularly around sensitive health data (e.g., reproductive or behavioral health).

The JARALL Solution: Comprehensive Risk Management

JARALL’s expert network ensures your compliance extends beyond the billing office. We partner with security specialists to conduct thorough Risk Assessments that identify and mitigate vulnerabilities before a breach occurs, and our attorneys help draft compliant NPPs and Business Associate Agreements (BAAs) to protect you when working with third-party vendors.

2. Incorrectly Documenting Routine Foot Care (Q Modifiers & Medical Necessity)

For podiatrists, the rules around Routine Foot Care (RFC) remain one of the most heavily scrutinized areas by Medicare, leading to a disproportionate number of audits and recoupments by the Office of Inspector General (OIG).

The Pitfall: Missing or Unsupported Q Modifiers

Medicare generally excludes routine services like nail trimming or callus removal unless the patient has a qualifying systemic condition (e.g., severe diabetes, peripheral vascular disease) that makes the service medically necessary to prevent a more serious complication.

The legal pitfall here is failing to clearly link the service to the underlying condition using the correct Q modifiers (Q7, Q8, Q9) and, crucially, failing to document the required findings in the patient’s chart. If the documentation doesn’t show the qualifying condition and a physician’s finding (e.g., loss of protective sensation, infection), the claim is legally indefensible under audit, leading to a False Claims Act exposure.

The JARALL Solution: Documentation Protocol Experts

Our certified coders and documentation experts specialize exclusively in podiatry and understand the specific local coverage determinations (LCDs) required in your region. We provide clinical protocol templates that ensure every chart note captures the specific findings (e.g., pulses, sensation, history of previous complications) needed to justify the Q modifier and the medical necessity of the service.

3. Ignoring Stark Law’s “Strict Liability” in Financial Relationships

The Stark Law (Physician Self-Referral Law) is one of the most unforgiving regulations in healthcare because it is a strict liability statute. This means a violation can occur even if you had no intention of breaking the law.

The Pitfall: Flawed Leases or Management Service Agreements (MSAs)

The Stark Law prohibits a physician from referring a Medicare or Medicaid patient for certain Designated Health Services (DHS) (like clinical lab services or physical therapy) to an entity with which the physician or a family member has a financial relationship, unless an exception applies.

Common pitfalls involve:

  • Leasing Office Space: Paying rent that is above Fair Market Value (FMV), or having a lease agreement where the rent is calculated based on the volume or value of referrals.
  • Management Contracts: Paying a clinic manager or administrator compensation that exceeds FMV for their work, or not having the agreement documented in writing.

For podiatry, if you refer patients for X-rays or lab work to a facility where you have an ownership stake, the arrangement must fit a precise Stark Law exception, or every resulting claim is tainted.

The JARALL Solution: Legal Review on Demand

Through our affiliated healthcare attorneys, JARALL helps you structure compensation, lease, and management agreements to fit the available safe harbors and exceptions. We ensure all financial arrangements are documented in advance and comply with the crucial Fair Market Value standard, safeguarding your practice from civil penalties and claim denials.

4. Unknowingly Committing Fraud Under the False Claims Act (FCA)

The False Claims Act is the government’s primary tool for combating healthcare fraud. A major risk is that many billing errors—which start as mistakes—can be interpreted as deliberate fraud if they are systemic and recurrent.

The Pitfall: Recurrent Upcoding or Unbundling of CPT Codes

The government can argue that repeatedly submitting claims that lack medical necessity or that use inaccurate codes (a practice known as upcoding or unbundling) demonstrates a “reckless disregard” for the truth.

In podiatry, this often manifests as:

  • Billing a higher-level Evaluation and Management (E/M) code than warranted by the documentation.
  • Unbundling procedures that should be combined and billed with a single CPT code.
  • Billing services that are clearly non-covered by Medicare without informing the patient or obtaining an Advance Beneficiary Notice of Noncoverage (ABN).

Penalties under the FCA are devastating, including fines up to three times the amount of the fraudulent claim, plus penalties per claim.

The JARALL Solution: Proactive Internal Audits

The best defense is not to be audited in the first place, or if you are, to have a proven track record of internal self-correction. JARALL implements a continuous auditing process, where our experts review a sample of your charts against the submitted claims to spot recurrent errors. We identify the training gap (e.g., a documentation flaw) and fix the system to ensure future claims are clean, demonstrating your commitment to compliance.

5. Failing to Update Business Associate Agreements (BAAs)

The focus on third-party vendor security has never been higher. Your business associates—anyone who creates, receives, maintains, or transmits PHI on your behalf (including your billing company)—are directly subject to HIPAA.

The Pitfall: Using Outdated or Generic BAAs

If your practice uses an old BAA, or a generic one provided by a non-specialized vendor, you may lack crucial protections. In the event of a vendor-caused data breach, the lack of a proper BAA can shift liability to your practice, exposing you to fines and reputational damage.

Furthermore, with the expected 24-hour breach reporting obligations for business associates under the new security rule updates, a slow or ill-defined BAA could leave your practice in non-compliance with the required reporting timelines.

The JARALL Solution: Managed Vendor Compliance

JARALL takes its BAA obligations seriously. When you partner with us, you are engaging a company whose entire network—from billing specialists to IT security partners—is vetted for current HIPAA and privacy rule compliance. We ensure our BAA protects your practice fully and that our incident response is rapid and compliant with new, accelerated federal reporting requirements.

Protect Your Practice. Secure Your Revenue.

The complexities of regulatory compliance—from the strict liability of Stark Law to the evolving demands of HIPAA 2026—are too great for any practice to manage alone. Legal pitfalls directly lead to financial jeopardy.

JARALL Medical Management is your comprehensive partner. We combine certified podiatry billing and coding expertise with a dedicated network of healthcare attorneys, HR specialists, and compliance experts. We don’t just process claims; we build a defensible revenue cycle that protects your practice for the long term.

Ready to start your 2026 compliance planning?

Contact JARALL today for a complimentary Practice Health Checkup.