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Compliance Healthcare Reform

Compliance programs typically refer to formalized institutional procedures within corporations and organizations to detect, prevent and respond to indvidual and widespread instances of regulatory violations. ... more +
Compliance programs typically refer to formalized institutional procedures within corporations and organizations to detect, prevent and respond to indvidual and widespread instances of regulatory violations.  In response to many corporate scandals evidencing rampant unethical business practices, many nations, including the United States, began passing strict regulatory frameworks aimed at curbing these abuses. Notable pieces of legislation in this area include the U.S. Foreign Corrupt Practices Act (FCPA), Sarbanes-Oxley (SOX), and the U.K. Bribery Act, to name a few. The foregoing statutes and the severe penalties often associated with them form the basis of many modern institutional compliance programs. less -
Mintz - Health Care Viewpoints

Will Sustained Pressure on the 340B Program Finally Lead to Much Needed Reform?

As we enter into the final months of 2024, new developments in the administration of the 340B Drug Pricing Program signal that additional reform may be on the way. Although recent revisions to the 340B program’s...more

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

Sheppard Mullin Richter & Hampton LLP

FemTech Meets DiagnosTech: A Discussion with Dierdre O’Neill

Emerging technologies are prompting a revolution in women’s healthcare through advanced diagnostic testing. In the sixth episode of Sheppard Mullin’s Health-e Law Podcast, Deirdre O’Neill, Chief Commercial & Legal Officer at...more

Health Care Compliance Association (HCCA)

An international standard for healthcare quality management

In October 2023, the International Organization for Standardization (ISO) published ISO 7101, Healthcare organization management: Management systems for quality in healthcare organizations. ISO 7101 is the latest in a series...more

Bradley Arant Boult Cummings LLP

Don’t Mess with Texas Nurses: Texas Healthcare Facilities Must Adopt Workplace Violence Prevention Plans by September 1, 2024

Texas has now joined states like California in creating statutory protections against workplace violence against healthcare workers. Senate Bill 240, now Chapter 331 of the Texas Health and Safety Code, requires healthcare...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

Health Care Compliance Association (HCCA)

News Briefs: September 11, 2023

The HHS Office for Civil Rights (OCR) on Sept. 7 announced a proposed rule to bar discrimination based on disability.[1] “The rule, Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal...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

NAVEX

From Healthcare Sector, a Big Push for CCO Autonomy

NAVEX on

For the better part of a decade, the U.S. Justice Department has led the way on calls for a strong, independent corporate compliance function – until recently, that is. Then the Department of Health and Human Services leaped...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

Health Care Compliance Association (HCCA)

Regulations, contracts, and credentialing for medical directors and attending physicians

There are many rules and regulations governing attending physician visits and medical directors. Unfortunately, there is plenty of room for error when documenting attending physician visits, establishing medical director...more

Health Care Compliance Association (HCCA)

What do burglars do on WFH Day?

Perhaps you haven’t pondered this question. On work-from-home days, do burglars break into their own homes? Or is this time spent doing research, preparing plans, taking online training courses on emerging best practices,...more

Butler Snow LLP

Health Care Due Diligence: An Ounce of Prevention is Worth a Pound of Cure

Butler Snow LLP on

Due diligence properly performed in connection with the purchase and sale of a health care entity is simply different—vastly so—than due diligence performed in other contexts. Failure to recognize this reality can lead to...more

Shumaker, Loop & Kendrick, LLP

How Important is Exclusion Screening for Health Care Providers?

Under its exclusion authority, the Department of Health and Human Services Office of Inspector General (OIG) has the power to exclude certain individuals and entities from receiving compensation from federally funded health...more

Sheppard Mullin Richter & Hampton LLP

CMS Releases Updates to Hospital Pricing Transparency Rule

On April 26, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released a fact sheet on Hospital Price Transparency Enforcement Updates (the “Fact Sheet”) under the Hospital Price Transparency Rule (the “Rule”)....more

Sheppard Mullin Richter & Hampton LLP

OIG’s Modernization of Compliance Program Guidance: What to Expect

The Department of Health and Human Services Office of Inspector General (OIG) recently announced changes to its process for informing healthcare industry stakeholders of new or updated Compliance Program Guidance (CPG)....more

McDermott Will & Emery

CMS Will Finalize Heightened Penalties, Additional Requirements Under Hospital Price Transparency Rule

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On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) announced that it will implement increased penalties for hospitals that do not comply with the Hospital Price Transparency Rule, effective January 1,...more

Bradley Arant Boult Cummings LLP

The Ongoing Saga of the CMS Hospital Price Transparency Rule

The Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule went into effect on January 1, 2021, but whether it will succeed in making prices readily comparable for healthcare consumers remains to be...more

Ballard Spahr LLP

Reporting for ACA Mandates: Final Forms and Additional Guidance

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The IRS has finalized the 2015 forms and instructions for reporting under the individual and employer mandates and issued additional guidance on these new reporting requirements. The following forms are now available...more

Manatt, Phelps & Phillips, LLP

Health Update - September 2015

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more

Epstein Becker & Green

Why Providers Should Think About the Impact of ICD-10 on Managed Care Reimbursement Now

Epstein Becker & Green on

ICD-10 implementation has been delayed by Medicare until October 2015. Many believe it may be delayed again and are putting off thinking about its impact until it is clear that the updated code set will be implemented by...more

Holland & Knight LLP

Recent 11th Circuit Cases Provide Important HIPAA Guidance - Healthcare Providers Should Be Proactive by Reviewing Their HIPAA...

Holland & Knight LLP on

On Oct. 10, 2014, the 11th Circuit opinion in Murphy v. Dulay provides significant guidance regarding HIPAA authorization forms. One of the most important provisions of the opinion focuses on the fact that HIPAA...more

Katten Muchin Rosenman LLP

Medical Staff Bylaws: Compliance Gaps and Best Practices - Part 1

In this presentation: - Background - Definitions - Purposes/Preamble - Nature of Medical Staff Membership - Qualifications for Membership - Insurance Requirements ... ...more

McDermott Will & Emery

Employer Shared Responsibility Payments and Reporting Requirements Under the Affordable Care Act: Code Sections 6055 and 6056

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Employer Shared Responsibility Penalties - There are two types of employer shared responsibility payments, also known as pay or play penalties, under the Affordable Care Act (ACA). The first penalty under Internal...more

Polsinelli

Don't Delay: Deadline for ICD-10 Compliance for October 1, 2015 Still Underway

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In a final rule released on July 31, the U.S. Department of Health and Human Services (HHS) confirmed October 1, 2015 as the compliance date for health care providers, health plans, and health care clearinghouses to...more

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