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

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Ambulatory Surgery Center Compliance Federal Settlement Raises Issues for Physician Owned Surgery Centers

Posted on September 30, 2014, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

A Federal Whistleblower that was recently settled in the United States District Court for the Middle District of Tennessee illustrates the difficult issues involved in structuring ambulatory surgery center ("ASC") investments. Specifically, the case demo…

CMS Releases the First Comprehensive Overhaul of Nursing Home Conditions of Participation in Over 25 Years

Posted on November 2, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

On October 4, 2016, the Center for Medicare and Medicaid Services (CMS) published a final rule to revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. CMS states that the revisions to nurs…

Lincoln’s Law Becomes Even More Absurd When Applied to the Health Care Industry

Posted on November 3, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

When Congress originally passed the False Claims Act (31 USC §§ 3729-3733), no one had the health care system in mind.  The False Claims Act was also commonly referred to as the “Lincoln Law”.  The original law was focused on unscrupulous vendors who pro…

Provider Self-Disclosure Decisions – Voluntary Disclosure Process

Posted on November 11, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The decision whether or not to voluntarily disclose non-compliance to the government can be very difficult.  Not every case is clear. Clearly not every situation where there has been a billing error amounts to fraud or wrongdoing requiring use of the …

When Does An Overpayment Become Fraud? How Simple Inattention Can Expose You to Penalties for Fraudulent Activities

Posted on November 11, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

If you are involved in any way in the health care system, it should be obvious by now that the government has committed ever increasing resources to the prosecution of fraud and abuse cases. Simply put, from a governmental standpoint, prosecuting fraud a…

False Claims Act Basics – Known Overpayment Becomes False Claim

Posted on November 11, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The Federal False Claims Act (“FCA”) provides a very strong enforcement tool to the federal government.  The FCA also provides the opportunity for whistleblowers to bring “qui tam” cases and collect a portion of the recovery where false claims are proved…

When Can Violation of a Condition of Participation Result in False Claims Act Liability? Update on Escobar’s Materiality Standard

Posted on November 17, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

In June, I published a blog article on a decision of the United States Supreme Court that appeared to change the law applicable to “false certification” in the 7th Judicial Circuit Circuit.  The Supreme Court decision in Universal Health Services v. Unit…

HHS Releases Inflation Adjusted Federal Civil Penalties

Posted on December 1, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The Department of Health and Human Services has issued new interim final rules to adjust a variety of Federal Civil Penalties for inflation.  The Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 required the agency to promulgate …

Recent Health Care Legal Developments – Looking Forward to 2017

Posted on December 29, 2016, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

As we are coming close to the end of another year, I thought it might be good to pull together some of the health law articles and blogs we produced during 2016.  Ruder Ware's Health Care Focus Team puts out a lot of information on a variety of different…

Lessons Learned from Recent OCR Settlements

Posted on January 26, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

We can learn some valuable lessons about compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) from settlements that are announced by the U.S. Department of Health and Human Services, Office for Civil Rights (OCR).  Thes…

OIG Report Indicates Areas of Hospice Fraud Vulnerability and Issues a Warning to Hospice Providers

Posted on January 27, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The HHS Office of Inspector General recently released a report indicating deficiencies in hospice election statements and physician certification of patient eligibility for hospice care.  Medicare hospice care provides help to patients who are terminally…

Compliance Officer and Legal Counsel Relationships

Posted on February 9, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

I am often asked my opinion whether a general counsel can also serve in the role of compliance officer.  At first blush, it seems the general counsel would be a perfect fit for the role because of general knowledge of regulations applicable to the organi…

Wisconsin DHS Prohibits Maneuvers and Techniques in Community Based Programs

Posted on February 10, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The Wisconsin Department of Health Services (DHS) released a memo specifying maneuvers or techniques that may not be used at any time in community based programs and facilities. DHS deems the prohibited maneuvers or techniques to "present an inherently h…

Home Health Agency Final Conditions of Participation Revisions Released by CMS

Posted on February 14, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The Center for Medicare and Medicaid Services has issued a final rule that revises and modernizes the Conditions of Participation (COP) for Home Health Agencies.  The Final Rule can be found in its entirety at: Final Home Health Rule (CMS-3819-F). The…

Confidentiality of Alcohol and Drug Abuse Patient Records - Final Rule Revising Regulations

Posted on February 17, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The Department of Health and Human Services (HHS) has released a final rule to update and modernize the Confidentiality of Alcohol and Drug Abuse Patient Records regulations effective February 17, 2017. The new regulations contain special confidential…

CMS Issues Proposed Rule to Increase Patients’ Health Insurance Choices for 2018

Posted on February 17, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

On February 17, 2017, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule aimed at reforming and stabilizing the individual and small group health insurance markets. When (or if) finalized, the proposed rule would make changes to…

Atlanta Dentist Goes to Jail for Medicaid Fraud - Do You Hear Me Now on Dental Practice Compliance?

Posted on February 21, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

A few months ago, the Atlanta Journal-Constitution reported on the guilty plea of an Atlanta dentist for Medicaid fraud.  Just this week, the dentist was sentenced to serve a year and a half in federal prison. The dentist was alleged to have netted ar…

CMS Recommendations Regarding Protection from Cybersecurity Risks

Posted on February 22, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

On January 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued Recommendations to Providers Regarding Cyber Security.  In general, the Recommendations are intended to remind providers and suppliers to keep current with best practices rega…

House Republicans and Trump Administration File Joint Motion to Delay Suit Challenging Obamacare Subsidies

Posted on February 23, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

An interesting development transpired Tuesday, February 21, 2017 in a case pending in Federal District Court in the District of Columbia that challenges subsidy payments from the Federal Treasury to support Obamacare.  The case was originally filed by Ho…

Department of Justice Issues Principles of an Effective Compliance Program

Posted on February 24, 2017, Authored by John H. Fisher, II
John H. Fisher, II
Attorney
Wausau Office
, Filed under Health Care

The Department of Justice issued a directive entitled “Evaluation of Corporate Compliance Programs.”  The document provides insight into the analysis used by the DOJ to assess the effectiveness of a corporate compliance program when making sentencing rec…