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Health Care Providers Healthcare Compliance

McDermott Will & Emery

Updated Mandatory Disclosure Requirements for Colorado Mental Health Providers Go into Effect

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On August 1, 2024, Colorado legislation took effect amending the mandatory disclosures that mental health providers must make to their clients under state law. Providers of mental health services in Colorado should take note...more

Health Care Compliance Association (HCCA)

Missing COI Program, Fabricated Outreach, Job, Health Records: The Many Types of Falsehoods

Report on Research Compliance 21, no. 9 (September, 2024) - How many types of falsehoods might sully applications for research funds and the studies they support? Unfortunately, the most recent semiannual report to...more

Health Care Compliance Association (HCCA)

Federation of State Medical Boards weighs in on ethical use of AI in clinical practice

Though responsible and ethical use of artificial intelligence (AI) has been a hot topic for the past few years, there has not yet been significant adoption of laws or regulations aimed specifically at regulating the use of AI...more

Manatt, Phelps & Phillips, LLP

Health Care Industry Is Next to Be Diagnosed With Waste Management Ailments in California

Over the course of the last two decades, non-industrial businesses in California have faced increased scrutiny of their compliance with the complex rules related to their management of regulated wastes, such as hazardous...more

Health Care Compliance Association (HCCA)

Overlapping surgeries: Time for a compliance checkup?

Overlapping surgeries is a practice that has been used for many years by healthcare providers (such as hospitals and surgical centers). This practice generally refers to situations where one lead attending surgeon is...more

Health Care Compliance Association (HCCA)

A partnership with HHS OIG

This year’s annual Compliance Institute (CI) provided a strong reminder of just how fortunate we are to have such a strong relationship with the U.S. Department of Health and Human Services Office of Inspector General (OIG)....more

Dentons

Ep. 23 – Addressing Patient Transportation Needs

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Lack of transportation can be a significant barrier to accessing healthcare services. According to a Robert Wood Johnson Foundation report, one in five patients report forgoing needed healthcare services due to lack of...more

ArentFox Schiff

Providers Face HIPAA Compliance Questions After Change Healthcare Cyberattack

ArentFox Schiff on

Who will notify the potentially millions of individuals whose information might have been jeopardized by the massive cyberattack on Change Healthcare? Since the affiliate of UnitedHealth Group (UHG) first reported the...more

Ankura

OIG Testimony Puts a Spotlight on Clinical Documentation and Payer Risk

Ankura on

In recent testimony before the United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Christi A. Grimm, Inspector General of the Department of Health and Human Services (HHS)...more

Holland & Hart LLP

New ACA 1557 Non-Discrimination Rules: Checklist For Healthcare Providers

Holland & Hart LLP on

On May 6, 2024, the Department of Health and Human Services (HHS) published its final rule revamping the non-discrimination regulations issued under § 1557 of the Affordable Care Act.  The revised rules apply to all...more

Dentons

Ep. 11 – Credentialing’s Important Role in Compliance

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Compliance is a “team effort.” Everyone in the organization has an important role to play. It’s critical, however, that each member of the team understand their specific role and how it relates to compliance. Compliance...more

Kerr Russell

Before You Sign—Minimizing Medical Director Liability Exposure

Kerr Russell on

Whether at a hospital, nursing home, surgical center or private office, physicians are encountering “Medical Director” opportunities more frequently than ever before. While physicians may be intrigued by the title,...more

Bradley Arant Boult Cummings LLP

State False Claims and AKS Statutes Keep Case Alive in 2nd Circuit: Underappreciated State Laws May Present Significant Compliance...

Recent years have seen eye-popping judgments and settlements involving cases brought under the federal False Claims Act (FCA) and federal Anti-Kickback Statute (AKS). And healthcare companies have, unsurprisingly, focused...more

Health Care Compliance Association (HCCA)

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

Health Care Compliance Association (HCCA)

Hospital Settles CMP Case Over Free APPs; 'Bona Fide' Use Shouldn't Inspire Fear, Lawyer Says

In a case that may hit a raw compliance nerve, Ascension Macomb Oakland Hospital in Michigan has agreed to pay $100,000 in a settlement with the HHS Office of Inspector General (OIG) over free services provided to certain...more

The Volkov Law Group

HHS-OIG Guidance — Practical Steps to Achieve Effective Compliance (Part III of III)

The Volkov Law Group on

Within the specific element discussions in HHS-OIG’s Guidance, are important operational details and strategies for an effective compliance program.  GCPG provides important suggestions and innovations for consideration by...more

McDermott Will & Emery

New Year, New Laws: California Healthcare Providers Subject to New Requirements in 2024

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The California legislature has created a lot of holiday homework for California healthcare providers, passing more than 50 new laws regulating a wide range of healthcare providers and healthcare business operations that apply...more

The Volkov Law Group

HHS-OIG Guidance — Chock Full of Compliance Best Practices and Strategies (Part II of III)

The Volkov Law Group on

Board Oversight of the Compliance Program - The GCPG cross-references the US Sentencing Guidelines board responsibility requirements of the organization’s compliance program, and provides that the board shall “be...more

The Volkov Law Group

HHS-OIG Issues Comprehensive Compliance Guidance that Underscores the Need for a Robust and Independent Compliance Function (Part...

The Volkov Law Group on

The health care industry has a rich history of commitment and innovation in developing effective compliance  programs.  Going back to the 1990s, HHS elevated compliance program requirements for healthcare companies. Many of...more

Bass, Berry & Sims PLC

HHS Releases Groundbreaking General Compliance Program Guidance, Setting New Standards for Healthcare Entities

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On November 6, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released the most up-to-date, comprehensive, and practical general compliance guidance in decades. The new...more

Wilson Sonsini Goodrich & Rosati

OIG Tackles New Issues in Its General Compliance Program Guidance: What Companies Need to Know

On November 6, 2023, U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a General Compliance Program Guidance (GCPG) as part of its plan to renovate its library of compliance program...more

Health Care Compliance Association (HCCA)

BA Depicted by OCR as Example of Ransomware Dangers Recovered Quickly, Didn’t Expect Fine

Report on Patient Privacy 23, no. 11 (November, 2023) Tim DiBona clearly remembers Christmas Eve 2018 when the staff of his small firm—Doctors’ Management Service (DMS)—arrived at their West Bridgewater, Mass., office to...more

Health Care Compliance Association (HCCA)

Privacy Briefs: November 2023

Report on Patient Privacy 23, no. 11 (November, 2023) The American Hospital Association (AHA) is urging federal lawmakers to intervene with the HHS Office for Civil Rights (OCR) so that hospitals and health systems can...more

Sheppard Mullin Richter & Hampton LLP

OIG General Compliance Program Guidance November 2023

In late April this year, the Office of Inspector General, Department of Health and Human Services (OIG) announced that it would make changes to its existing body of healthcare compliance program guidance (CPGs) as part of its...more

McDermott+

CPT Summary of Panel Actions: Update from the September 2023 Meeting

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The CPT® Editorial Panel met in New Orleans, Louisiana, from September 21 to 23, 2023 to consider proposals to create new current procedural terminology (CPT) codes and to revise or delete existing codes. The resulting...more

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