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74 Results for Articles by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
In The Blue Ink Blog.

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Antitrust Challenge to Narrow Network Products – 7th Circuit Rules in Favor of Exclusive Agreement

Posted on June 28, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The health care market has recently seen a resurgence in narrow network products.  To a significant degree, the resurgence of these products has been driven by the need for managed care plans looking for new avenues to help reduce the cost of care.  Trad…

Opioid Fraud and Abuse as a Compliance Risk Area

Posted on February 20, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The opioid epidemic is different than other drug related social problems because, in many cases, addiction to opioids starts in the medical office or in the pharmacy; in most cases through the treatment of legitimate physical pain and often chronic pain.…

Will Centers for Medicare & Medicaid Services (CMS) Really Make Changes to the Stark Law?

Posted on February 26, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

If you navigate to the American Hospital Association (AHA) Interactive Town Hall of January 17, 2018, you can view a video in which Seema Verma, the current Administrator of the Centers for Medicare and Medicaid Services, discusses some of the efforts cu…

When Does a HIPAA Breach Exist?

Posted on April 3, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

Conducting HIPAA Breach Risk Assessments The HIPAA rules relating to assessment of potential patient confidentiality breaches were changed in 2013.  Specifically, on January 17, 2013, the Office of Civil Rights released new regulations defining when a…

What HIPAA Policies are Required for a Health Care Provider?

Posted on April 5, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

We are often asked to advise clients regarding the scope and content of Health Insurance Portability and Accountability (HIPAA) policies and procedures that are required to be maintained.  HIPAA clearly requires health care providers, as “covered entitie…

Office Inspector General Launches New Compliance Resource Portal

Posted on April 30, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 enough, there is a brand spa…

Recent Fraud Settlements Illustrate Current Compliance Risk Areas

Posted on May 17, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 indicative of the areas of fraud enforcement they feel are im…

Treatment Center Pleads Guilty to Anti-kickback Statute Violations Involving Alcohol and Drug Addiction Treatment Centers

Posted on May 24, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 dollar health care fraud and money laundering scheme…

Complying with Michigan’s New Controlled Substance Laws – The Bona-Fide Prescriber-Patient Relationship Requirement

Posted on May 29, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 physician and a patient. Generally, Michigan requires a…

Can an ACO Violate the Antitrust Laws?

Posted on June 21, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 involving an Accountable Care Organization (ACO) that par…

Non-Economic Damage Limitation Upheld by the Wisconsin Supreme Court

Posted on July 11, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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, overturned a lower court decision that found the non-…

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

Posted on August 30, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 services to caregivers in the local community (Arrangemen…

OIG Opinion on Donation of Telehealth Equipment

Posted on September 5, 2018, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 of telehealth equipment.  The OIG has issued opinion…

New CMS Rules for Inpatient Rehabilitation

Posted on May 13, 2019, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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.  Any change that reduces paperwork in this overregulate…

DOJ's New Evaluation of Corporate Compliance Programs - A Good Time to Focus on the Essence of Compliance

Posted on May 20, 2019, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 first introduced in 2017 to provide guidance for prosecu…

HIPAA This, HIPAA That. Everything is a HIPAA Issue. Deconstructing the "HIPAA Bias."

Posted on May 22, 2019, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 and that it protects the confidentiality of a patient’…

The Essence of Compliance - Compliance Officer Authority and Resource Allocation

Posted on May 24, 2019, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 to allocate sufficient revenues to the compliance…

The Federal Government Really Wants You to Self Disclose

Posted on May 28, 2019, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 and self-disclose where infractions are found.  The fa…

Apply the 60-Day Rule to Medicaid Overpayments

Posted on May 30, 2019, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 identified.  If an overpayment is not repaid, or if a…

Congress Creates a Mess by Enacting the Eliminating Kickbacks in Recovery Act of 2018

Posted on June 13, 2019, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

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 recovery homes, clinical treatment facilities, and laborato…

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