News & Analysis as of

Hospitals Audits Healthcare

Buchalter

Navigating Immigration Compliance in U.S. Hospitals: Key Concerns for Administrators and Providers

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The healthcare sector, a cornerstone of U.S. public infrastructure, relies heavily on a diverse and multinational workforce. From physicians to support staff, many hospital employees are immigrants—often working under...more

King & Spalding

OIG Releases Findings on Medicare Contractor Compliance with Medicare Cost Report Oversight Requirements

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Last week, OIG’s Office of Audit Services released its latest report on Medicare Administrative Contractors’ (MACs) compliance with Medicare cost report oversight requirements. The report, which is titled Medicare...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, V 2, Issue 2, January 2025

Welcome to our second issue of 2025 of The Health Record -- our healthcare law insights e-newsletter. In this edition, we look at the effect of the decline of DEI on the healthcare industry, the fate of Medicaid under the...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

ArentFox Schiff on

With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more

NAVEX

Addressing Cybersecurity Expectations in Healthcare

NAVEX on

2024 is shaping up to be a very active year for regulatory and enforcement developments in the healthcare industry – developments that concern not just hospitals and nursing facilities, but many non-healthcare companies as...more

McDermott Will & Emery

HIPAA Compliance 101: Lessons from a Recent OCR Settlement

McDermott Will & Emery on

The US Department of Health and Human Services Office for Civil Rights (OCR) recently announced a settlement with a community hospital resolving an investigation under the Health Insurance Portability and Accountability Act...more

Baker Donelson

OIG Hospital Compliance Audits: Is Your Number Up? Are You Ready?

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In its Work Plan for Fiscal Year 2012, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) announced it would begin reviews of Medicare payments to hospitals to determine compliance...more

Burr & Forman

Meaningful Use Audits: Proactive Tips for Success

Burr & Forman on

For health care professionals who began accepting Meaningful Use incentive money at the outset of availability under the Medicare option in 2011, the year 2015 is an important year. If the provider has met all core...more

Holland & Knight LLP

HHS Issues Proposed 340B Program Omnibus Guidance: Five Things to Watch

Holland & Knight LLP on

The 340B Drug Pricing Program (340B Program), established by Section 602 of the Veterans Health Care Act of 1992, is administered by the Health Resources and Services Administration (HRSA) of HHS. The 340B Program requires...more

King & Spalding

HRSA Publishes Proposed 340B Drug Pricing Program Omnibus Guidance - Comments Due to HRSA on or before Tuesday, October 27, 2015

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On Friday, August 28, 2015, the Health Resources and Services Administration (“HRSA” or “the Agency”) published in the Federal Register Notice of its proposed “omnibus” or “mega” guidance (“Proposed Guidance”) regarding...more

Robinson & Cole LLP

Connecticut Enacts Health Care Legislation in June Special Session

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On June 29 and 30, 2015, the Connecticut General Assembly conducted a special legislative session following the close of the 2015 regular session. Among other things, the General Assembly passed a bill to implement the state...more

Thomas Fox - Compliance Evangelist

Lessons from GSK in China – Internal Controls, Auditing and Monitoring

One of the questions that GSK will have to face during the next few years of bribery and corruption investigations is how an allegedly massive bribery and corruption scheme occurred in its Chinese operations? The numbers went...more

Troutman Pepper

Health Care in 2014: A Brave New World

Troutman Pepper on

With the completion of the enrollment phase of the Affordable Care Act (ACA), health care in the United States has entered a new era that will be characterized by extensive changes and challenges for both providers and...more

PilieroMazza PLLC

Victory in House of Representatives for Improvements to WOSB Federal Contract Program

PilieroMazza PLLC on

On May 7, 2014, the Office of Federal Contract Compliance Programs (OFCCP) issued Directive 2014-01, instituting a five-year moratorium on the OFCCP enforcement over TRICARE subcontractors. The moratorium applies to health...more

King & Spalding

Health Headlines: Also in the News - May 2014

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OIG Reports Jurisdiction H Contractors Made $3.3 Million in Overpayments for Outpatient Drugs – According to a recent OIG report, the Medicare Contractors for Jurisdiction H overpaid providers approximately $3.3...more

Dentons

HIPAA Impaired Providers and the ER - What Happens When Your Employee Becomes Your Patient?

Dentons on

I was speaking this week at IAHIMA’s Annual Conference on the issues relating to HIPAA audits and recent updates from OCR and ONC. As part of my program we typically solicit questions prior to the presentation, most of which...more

Williams Mullen

Possible Hospital RAC Audits in 2014: Pow! Right in the Kisser!

Williams Mullen on

Whew…it’s a new year. While I thoroughly enjoyed 2013, I am excited and hopeful for 2014. Work is so busy that it seems like I’ve barely had time to breathe this January….that’s a good thing, right? Hey, anyone see me on...more

Baker Donelson

CMS Issues Additional Guidance Related to 2-Midnight Rule

Baker Donelson on

Earlier this month, CMS posted three new documents related to the 2-midnight rule for inpatient admissions on its webpage for inpatient hospital reviews: new FAQs, as well as CMS directions for selecting hospital claims for...more

McDermott Will & Emery

Preparing a Hospital or Health System for Sale or Partnership Transactions – Part Two

McDermott Will & Emery on

The consolidation trend in hospital and health systems continues. To address perceived inefficiencies and quality of care issues, hospitals are attempting to form larger enterprises to create scale, expand geographically,...more

The Volkov Law Group

Hospitals: Audits And Compliance

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Hospitals are under intense scrutiny. The federal government knows that one sure way to reduce healthcare costs is to get hospitals to lower their costs. Hospitals feel the pinch given the need to generate revenue but know...more

The Volkov Law Group

Protecting Your Hospital From Over-Utilization Prosecutions

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The government has been increasing its focus on healthcare fraud involving “quality” of care. This is an extremely difficult issue, especially for prosecutors. It is very difficult to define “quality” standards and then...more

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