IN THIS ISSUE:

“Double Jeopardy”: The Contractual Enforcement of Healthcare Laws and Regulations in Payor Agreements; Tax and Exempt Provider News; Healthcare Reform News; Reimbursement News; Licensing, Fraud and Abuse and Compliance News; and, Healthcare IT News.

Excerpt from "Double Jeopardy" - The Contractual Enforcement of Healthcare Laws and Regulations in Payor Agreements:

In a recent review of a client’s proposed payor agreement with a state agency, I found several disturbing provisions that were buried deep within the “boilerplate” provisions under a “Special Requirements” category. By signing the proposed renewal agreement, the client agreed to comply with several federal healthcare laws and regulations. Despite its being required to comply with the referenced statutes anyway, because the client incorporated these new provisions into its renewed payor agreement, the client will also be in default with this agreement if it fails to comply with the federal provisions. Even though this payor agreement was the annual renewal of an expiring agreement for the same client with the same governmental agency, these provisions were new and were not found in the expiring agreement...