News & Analysis as of

Healthcare Chief Compliance Officers

Health Care Compliance Association (HCCA)

Picture this: Data visualization

As most of you who’ve heard me speak or read my columns know, I’m a strong supporter of using data analytics in compliance programs. It’s an important tool that all compliance professionals should have a working understanding...more

Foley & Lardner LLP

Compliance Compass: The Erlanger Complaint – A Cautionary Reminder About the Importance of FMV

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Although most health care lawyers and compliance officers who review and analyze physician compensation understand that fair market value (FMV) is important, the nuances around FMV are sometimes missed....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

Health Care Compliance Association (HCCA)

Explore the how and the why

Anytime a compliance violation occurs—or even a breakdown in compliance controls that doesn’t ultimately result in noncompliance—the remediation process takes center stage. And this is where questions of how and why are...more

Dentons

Ep. 9 - Building a Compliance Dream Team

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Most healthcare providers understand the importance of having a designated Compliance Officer.  Someone needs to lead the organization’s compliance initiatives and be responsible for advising the CEO and governing body of...more

Health Care Compliance Association (HCCA)

The compliance lessons in the wake of the Supreme Court decision in U.S. ex rel Schutte v. SuperValu, Inc.

The False Claims Act (FCA) permits private individuals to bring lawsuits in the name of the United States—called qui tam—against those they believe have defrauded the federal government: 31 U.S.C. § 3730(b). The FCA thereby...more

Dentons

Ep. 7 – Be a Problem Solver, Not a Prosecutor

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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

Society of Corporate Compliance and Ethics...

Good news, bad news

There’s good and bad news out there for compliance departments, and it’s also the same news: Governments now very much appreciate strong compliance programs. On the one hand, that is very good (if not great!) news....more

Health Care Compliance Association (HCCA)

The case for autonomy and resources

There it is on page 39, under “Compliance Leadership and Oversight: The Compliance Officer’s Primary Responsibilities”: “. . . the compliance officer should not lead or report to the entity’s legal or financial...more

Health Care Compliance Association (HCCA)

HHS OIG General Compliance Program Guidance: An empowered and independent compliance function

Corporate Compliance & Ethics Week 2023 kicked off with a gift for healthcare and life sciences compliance practitioners by way of the U.S. Department of Health and Human Services (HHS) Office of Inspector General’s (OIG)...more

Health Care Compliance Association (HCCA)

Behavioral health, artificial intelligence, and compliance

Technology’s exponential development and use in healthcare provides potentially significant benefits for behavioral health patients but also raises ethical and compliance concerns. The most recent technological advance...more

NAVEX

From Healthcare Sector, a Big Push for CCO Autonomy

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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

Fox Rothschild LLP

In Case You Missed It: New OIG General Compliance Program Guidance

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On November 6, 2023, the HHS Office of Inspector General published a new compilation of compliance guidance under the title General Compliance Program Guidance (GCPG) for the healthcare compliance community and other health...more

Health Care Compliance Association (HCCA)

A busy year for OIG

On April 24, at this year’s Compliance Institute, the U.S. Department of Health & Human Services (HHS) Inspector General (IG) Christi Grimm announced an important initiative, which was posted in the Federal Register the next...more

Health Care Compliance Association (HCCA)

Adding some spice to your compliance program

Every quarter, each acute care hospital that is paid under the Inpatient Prospective Payment System has access to an Excel workbook that contains valuable information about your hospital’s compliance with myriad Medicare...more

Health Care Compliance Association (HCCA)

Can compliance officers unring the bell?

Ideally, compliance officers are brought into their organization’s discussions about potential business deals at the outset to help ensure they start on a compliant path. Unfortunately, compliance officers are sometimes asked...more

Health Care Compliance Association (HCCA)

Supreme Court leaves open a major risk to internal corporate communications

It is commonplace for attorneys and compliance officers (particularly those who are also attorneys) to receive communications from clients that have more than one purpose. Take, for example, a doctor who calls a friend and...more

Health Care Compliance Association (HCCA)

Enforcement actions relating to a lack of medical necessity

In a climate of shrinking margins, diminishing reimbursement, and frequent denials, healthcare organizations may make efforts to increase the volume of services they provide, especially those that are more profitable. Of...more

Ankura

Behind the Expert: Applying a Proactive Approach to Healthcare Compliance with Nancy Waltermire

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"Rather than reacting, you must be proactive and preventive. By doing this, you will not only be prepared for the potential obstacles that face your company, but you will most likely eliminate obstacles before they appear." ...more

Health Care Compliance Association (HCCA)

Compliance Programs and Doubt Mining

The compliance team has a new initiative, or you need to tell the business unit that, if it wants to get into a new line of business, a list of compliance requirements need to be implemented. Even if there is no overt...more

Health Care Compliance Association (HCCA)

[Event] 2020 Virtual Columbus Regional Conference - May 1st, Columbus, OH

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

Health Care Compliance Association (HCCA)

[Event] 2020 Healthcare Enforcement Compliance Conference - November 15th - 18th, Washington, DC

Regulations play a major role in the health care industry and it can be overwhelming to understand and stay on top of everything. This conference is a once-a-year opportunity to gain insight into properly monitoring,...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - January 13th - 16th, Lake Buena Vista, FL

HCCA's Basic Compliance Academy is a three-and-a-half-day intensive training program focusing on subject areas at the heart of health care compliance practice. Its faculty is made up of experts in the field. Courses are...more

Ruder Ware

Office Inspector General Launches New Compliance Resource Portal

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At a recent Health Care Compliance Association (HCCA) compliance institute, the Office of Inspector General announced it had launched a new resource portal focused on compliance issues. A trip to the OIG's web site, and sure...more

Akin Gump Strauss Hauer & Feld LLP

Minimizing Exposure to Stark Law Liability in False Claims Act Cases by Isolating Those Who Determine Fair Market Value From Those...

I. Stark Law and False Claims Act - The FCA has become the primary enforcement vehicle for the Ethics in Patient Referrals Act, better known as the Stark Law. There are now more than 150 public cases citing to both the...more

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