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Office Inspector General Launches New Compliance Resource Portal

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...

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Recent Fraud Settlements Illustrate Current Compliance Risk Areas

One of the reasons compliance officers and health care attorneys read fraud settlements is to identify issues the government is focused on.  The cases the government decides to pursue are very...

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Treatment Center Pleads Guilty to Anti-kickback Statute Violations Involving...

The Department of Justice (DOJ) recently announced the guilty plea of two individual alcohol and substance abuse treatment center owners for their participation in what the DOJ labeled a “multi-million...

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Complying with Michigan’s New Controlled Substance Laws – The Bona-Fide...

The state of Michigan has enacted a number of separate pieces of legislation to address the opioid epidemic.  Most of these laws are directed at controlling the prescribing relationship between a...

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DOJ Focuses Antitrust Enforcement on Health Care Industry

As health care attorneys we are often called upon to consider the antitrust implications in a variety of contracts and transactions.  For example, the establishment of clinically integrated health care...

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Can an ACO Violate the Antitrust Laws?

This may not be obvious to people who do not keep track of the Federal Trade Commission (FTC)/Department of Justice antitrust enforcement policy, but an enforcement action has never been published...

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Non-Economic Damage Limitation Upheld by the Wisconsin Supreme Court

The Wisconsin Supreme Court has issued a ruling in the case of Mayo v. Wisconsin Injured Patients and Families Compensation Fund.  The Supreme Court’s decision, which was handed down on June 27, 2018,...

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Hospital Program for Free Support Services for Caregivers – Approved by OIG

A recent Office of Inspector General (OIG) advisory opinion approved a proposal under which a hospital has established a caregiver center that provides or arranges for free or reduced-cost support...

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OIG Opinion on Donation of Telehealth Equipment

A recent Advisory Opinion (Advisory Opinion 18-03) from the Office of Inspector General (OIG) of the Department of Health and Human Services addresses potential kickback issues involved in the donation...

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CMS Proposes Rule to Ease Compliance Requirements

Last month, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule designed to, in CMS’s words, “relieve burden on healthcare providers by removing unnecessary, obsolete or...

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New CMS Rules for Inpatient Rehabilitation

Well, it’s a start.  New Medicare rules kicked in starting January 1, 2019 that are aimed at focusing less provider time on paperwork and more on patient care in inpatient rehabilitation facilities....

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DOJ’s New Evaluation of Corporate Compliance Programs – A Good Time to Focus...

The Criminal Division of the United States Department of Justice (DOJ) recently released an update (April, 2019) to its Evaluation of Corporate Compliance Programs (Evaluation).  The Evaluation was...

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HIPAA this, HIPAA that. Everything is a HIPAA Issue. Deconstructing the...

HIPAA, as a body of regulations protecting the confidentiality of patient health care information, has been branded very effectively.  Most staff at your average health care facility know about HIPAA...

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The Essence of Compliance – Compliance Officer Authority and Resource Allocation

How Are Compliance Budgeting and Compliance Officer Autonomy Tied Together When Assessing Compliance Effectiveness? The Department of Justice (“DOJ”)’s compliance program evaluation identifies the need...

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The Federal Government Really Wants You to Take Self Disclose

The Department of Justice (DOJ) along with other health care fraud enforcement agencies, continue to send strong signals that they want businesses to police themselves for potential compliance issues...

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Apply the 60-Day Rule to Medicaid Overpayments

The Affordable Care Act requires any person who has received an overpayment from certain defined government health programs to report and return the overpayment within 60 days after the overpayment is...

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Congress Creates a Mess by Enacting the Eliminating Kickbacks in Recovery Act...

Congress has activated a new Anti-Kickback law known as Eliminating Kickbacks in Recovery Act of 2018 (commonly referred to as EKRA).  The new Anti-Kickback law applies to arrangements involving...

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Proposed Revisions to the SAMHSA Regulations Would Permit Non-Part 2...

Our representation of behavioral health and substance abuse programs has required us to stay in tune to issues involving special confidentiality of patient records under 42 CFR Part 2, also known as...

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How the Stark Law Waivers Can Help Combat the Coronavirus

The Centers for Medicare & Medicaid Services published at the end of March new blanket waivers under the federal physician self-referral law (commonly known as the Stark Law) in response to the...

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CMS Issues Guidance On Resuming Non-COVID-19 Care In Areas That Have Low...

The Centers for Medicare & Medicaid Services (CMS) have issued new recommendations targeted at communities in Phase 1 of the Guidelines for President Trump’s “Opening Up America Again.”  The Phase...

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