On February 25, 2025, President Trump signed an Executive Order directing federal agencies to “rapidly implement and enforce” federal healthcare price transparency regulations....more
Many healthcare organizations understand the importance of having a Compliance Committee but some struggle to use their committee effectively. The key to ensuring the Compliance Committee is effective is building smart...more
3/3/2025
/ Compliance ,
Compliance Monitoring ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
OIG ,
Policies and Procedures ,
Regulatory Requirements ,
Risk Assessment ,
Risk Management
In January, the Department of Justice released its annual fraud statistics summarizing health care fraud settlements and judgments during the 2024 fiscal year. Last year, there were over $2.9 billion in fraud settlements and...more
2/27/2025
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Physician Payments ,
Physicians ,
Settlement ,
Stark Law ,
Whistleblowers
It is not uncommon for healthcare providers to want to offer employees a discount on their services as a way to show their appreciation and as an added benefit to retain and attract candidates. While these discount programs...more
“Almost every stage of modern healthcare relies on stable and secure computer and network technologies.”
The above is a direct quote from the Office of Civil Rights for Health & Human Services (“OCR”) in its proposed...more
1/31/2025
/ Cybersecurity ,
Data Breach ,
Data Privacy ,
Data Security ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Technology ,
Healthcare ,
HIPAA Security Rule ,
OCR ,
Patient Privacy Rights ,
Risk Management
As we routinely discuss on the podcast, much of the success of an organization’s compliance program depends on its culture. Creating and fostering a compliance-minded culture can help ensure employees report suspected...more
Providers are required by federal law to return Medicare and Medicaid overpayments within 60 days of identifying the overpayment or they can be liable under the False Claims Act. Since 2016, providers have relied on Centers...more
As we start a new year, January is a great time to plan ways to refresh your compliance programming for the upcoming year. Compliance training and activities can become stale. They often take a backseat to the day-to-day...more
As the ultimate decision-maker for your organization, your governing body needs to understand compliance and appreciate the compliance risks facing the organization as well as what is needed to mitigate those risks. This...more
Last month the Office of Inspector General for the U.S. Department of Health & Human Services (OIG) released its first industry-specific compliance program guidance aimed at nursing facilities (both skilled and non-skilled)....more
Holiday gifts are a common marketing tool used by many businesses; however, in healthcare, they can create compliance issues. Most healthcare providers have a gift policy that limits the type of gifts and other business...more
The Centers for Medicare & Medicaid Services (CMS) is in the midst of an off-cycle revalidation process for all Medicare-participating skilled nursing facilities (SNFs), requiring them to submit much more information...more
In September, the United States Department of Justice (DOJ) updated its corporate compliance program guidance which outlines criteria to look for in determining whether an organization’s compliance program is “adequate and...more
In healthcare, compliance issues can quickly escalate into compliance nightmares, with serious implications for patient safety, legal liability, and an organization’s reputation. Among the most common compliance nightmares...more
Effective December 23, 2024, HIPAA-covered entities and their business associates will be required to comply with new restrictions on how protected health information may be used and disclosed for certain purposes relating to...more
Healthcare workers nationally are facing an increase in workplace violence, often instigated by patients and visitors. A study published earlier this year reported that almost 20% of healthcare workers have faced physical...more
10/17/2024
/ Employer Liability Issues ,
Essential Workers ,
Health and Safety ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
Healthcare Workers ,
Nurses ,
Patients ,
Physicians ,
Termination Rights ,
Workplace Safety ,
Workplace Violence
Earlier this year, the US Department of Health & Human Services (“HHS”) released updated regulations governing the use and disclosure of substance use disorder records, referred to as “Part 2.” The Part 2 rules protect...more
On March 27, 2020, Congress enacted the Coronavirus Aid, Relief & Economic Security Act (CARES Act) which included provisions requiring the U.S. Department of Health & Human Services (“HHS”) to better align the federal...more
It’s extremely hard to change an organization’s culture, but no one is in a better position to influence an organization’s culture than its Chief Executive Officer. Compliance starts at the top, and it’s important CEOs are...more
Looking for a simple, easy-to-implement way to lower your risk of overpayments? We have one on this week’s podcast!...more
Most healthcare providers understand that routinely waiving patient cost-sharing obligations creates compliance issues under the Anti-Kickback Statute, the Civil Monetary Penalties Law, and third-party payor agreements which...more
Providers will often pay physicians for serving in important administrative roles within the organization. Compensation for administrative services can create risk to the organization under multiple laws, including the...more
One of the fundamental compliance requirements for healthcare providers is protecting the confidentiality and security of the patient health information you maintain. Most healthcare providers are subject to a federal law...more
Has a patient asked you or one of your providers if they could record a conversation or interaction with you? Would your staff know how to handle such a request? Requests from patients and their families to record...more
One of the biggest changes in healthcare over the past 15 years has been the move to electronic medical records. In 2009, only 12% of hospitals and 22% of physician practices utilized a certified electronic health record. As...more