Sometimes we forget that even small and medium-sized providers can run afoul of antitrust laws and regulations. Often these activities are well-intentioned. It’s not uncommon for competing providers to want to work together...more
Given the highly regulated nature of healthcare, it should come as no surprise that most healthcare providers have a designated compliance officer tasked with overseeing the implementation and management of the organization’s...more
The compliance officer is one of the most important positions within the organization, but also one of the most challenging. You’re expected to be a teacher, a coach, a project manager, a good listener, and a role model....more
Healthcare providers, their employees, medical staff, and patients have long been protected by Federal conscience protections preserving their right to participate in, or refuse to participate in, lawful activities which may...more
Fiscal year 2023 saw record recoveries and the highest number of settlements and judgments ever under the Federal False Claims Act. According to a new report released by the United States Department of Justice (“DOJ”), the...more
3/4/2024
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Final Judgment ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Fraud ,
Qui Tam ,
Regulatory Violations ,
Settlement ,
Whistleblowers
Fiscal year 2023 saw record recoveries and the highest number of settlements and judgments ever under the Federal False Claims Act. According to a new report released by the United States Department of Justice (“DOJ”), the...more
Diabetes and obesity drugs have skyrocketed in popularity as of late. According to a report released by Trilliant Health in September 2023, healthcare providers in the United States wrote more than 9 million prescriptions for...more
In November 2023, the United States Health & Human Services Officer of Inspector General (“OIG”) issued new compliance program guidance for the healthcare industry, referred to as the General Compliance Program Guidance...more
When was the last time your organization received an anonymous compliance concern? Has it been so long you can’t recall? Maybe you consider yourself lucky that the organization has never received a concern on your watch, or...more
2/8/2024
/ Anonymity ,
Anti-Corruption ,
Compliance Management Systems ,
Corporate Governance ,
Corporate Management ,
Corporate Misconduct ,
Employer Liability Issues ,
Health Care Providers ,
Healthcare Facilities ,
Internal Reporting ,
Whistleblowers ,
White Collar Crimes
Is your organization’s culture complimenting your healthcare compliance program? Does it enhance and maximize your program’s effectiveness? Or, is your culture secretly sabotaging your compliance efforts?...more
Are you a health care provider who received funds from the Health Resources and Services Administration's ("HRSA' s") COVID-19 Uninsured Program? If so, more inquiries and repayment demands may be coming....more
On July 7, 2023, the Consumer Financial Protection Bureau, U.S. Department of Human Services, and U.S. Department of Treasury (collectively, the “agencies”) launched an inquiry into high-cost specialty financial products...more
On December 2, 2022, Health & Human Services issued guidance (HHS) delaying the requirement that convening providers include co-provider charges in their good faith estimates for self-pay patients. Previously, the requirement...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect uninsured patients from surprise billing. Some sections of the NSA became effective on January 1, 2022, while other sections are on hold until...more
9/2/2022
/ Billing ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Out-of-Pocket Expenses ,
Surprise Medical Bills
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect uninsured patients from surprise billing. Some sections of the NSA became effective on January 1, 2022, while other sections are on hold until...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect uninsured patients from surprise billing. Some sections of the NSA became effective on January 1, 2022, while other sections are on hold until...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect uninsured patients from surprise billing. Some sections of the NSA became effective on January 1, 2022, while other sections are on hold until...more
Congress passed the No Surprises Act to protect patients from surprise billing from health care providers. Some parts of the Act became effective on January 1, 2022. Health care lawyer Susan Freed is answering frequently...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect patients from surprise billing. Some sections of the NSA became effective January 1, 2022, while other sections are on hold until regulations are...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect patients from surprise billing. Some sections of the NSA became effective January 1, 2022, while other sections are on hold until regulations are...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect patients from surprise billing. Some sections of the NSA became effective January 1, 2022, while other sections are on hold until regulations are...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect patients from surprise billing. Some sections of the NSA became effective January 1, 2022, while other sections are on hold until regulations are...more
In the first article of this Health FSA series, we covered how to determine if an employer’s Health FSA is discriminatory. In the second and final article of this series, we’ll cover what employers should consider if their...more
Employers often provide an array of benefits to employees. One such benefit is a Health Flexible Spending Account (Health FSA). These accounts allow employees to contribute pre-tax dollars to be used for unreimbursed medical...more
In the wake of the United States Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, many companies have announced plans to assist employees in accessing abortion services, including providing travel...more