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OCR Settlement Lessons – Failing to Perform an Electronic Access Risk Analysis Before an Unauthorized Access Occurs

Posted on May 3, 2017 by

Failure to conduct a risk assessment before a hacking incident occurred resulted in a $400,000 settlement between the Office of Civil Rights (OCR) and a Federally Qualified Health Clinic (FQHC).  The FQHC filed a breach report upon learning its employee emails had been hacked and the hacker had access to electronic health information of over […]

Seventh Circuit Court of Appeals Speaks Out on Employment Issues

Posted on May 3, 2017 by

Several recent decisions by the Seventh Circuit Court of Appeals have set the tone for court decisions in the employment law field.  The Seventh Circuit Court of Appeals covers a number of states in the Midwest, including Wisconsin, so the rulings are important for Wisconsin employers up to a point.  The first decision involves sexual […]

Banks and Credit Unions Agree to a (Temporary) Cease Fire

Posted on April 27, 2017 by

It’s not every day that community bankers and credit unions agree. Whether it is over tax-exempt status or capital requirements, we have become accustomed to the battle between community banks and credit unions.  For example, an entire section of the Independent Community Bank Association’s website is dedicated to advocating against the “expansionist agenda” of credit […]

Suggested Questions for the Compliance Officer

Posted on April 19, 2017 by

In a previous blog post, I promised to release a list of questions a Board of Directors (Board) might ask its compliance officer.  This post is intended to fulfill that promise.  My intent is to help Board members exercise their oversight responsibility, assess the compliance officer, and further their understanding of the compliance program and […]

Exercising Board Oversight of the Compliance Function

Posted on April 19, 2017 by

How the Board can Enhance Compliance Effectiveness The Board of Directors (Board) of an organization has oversight responsibilities over the compliance program.  Board members are often unsure of the nature and scope of their responsibilities over compliance.  The roll of many Boards is limited to receiving occasional updates from the compliance officer.  Compliance is then […]

Are Too Many Eggs in One Basket?

Posted on April 19, 2017 by

In the last two weeks, 75 Wisconsin dairy farmers were notified by their dairy that it could not accept their milk.  The dairy and its farmer suppliers are caught in a U.S.-Canada trade dispute over “ultra-filtered” milk.  Almost overnight, a market disappeared. The net result is a million pounds of milk per day in Wisconsin […]

Self-Disclosure Has Become a Normal Part of the Compliance Process

Posted on April 12, 2017 by

As the Office of the Inspector General and Centers for Medicare & Medicaid Services make self-disclosure easier for providers, we have noticed an increase in the rate of cases that are being filed.  Assisting providers in making decisions whether to self-disclose, conducting internal investigations, and guiding the self-disclosure process when appropriate has become a large […]

Ambulatory Surgery Center (ASC) Case Demonstrates Differential Value Theory of Remuneration

Posted on April 11, 2017 by

A relatively recent case involving buy-in terms in an ambulatory surgery center demonstrates how different valuations for referral sources and non-referral sources can be evidence of remuneration under the Medicare Anti-Kickback Statute (42 U.S.C. § 1320a-7b(a)-(b)).  The case also demonstrates how the initial investment terms that favor referral sources can foreclose reliance on safe harbor […]

Can Overpayments Create Criminal Liability?

Posted on April 11, 2017 by

We hear a lot about potential liability under the False Claims Act (FCA) for the failure to repay overpayments within 60 days of discovery. Focus on the 60-day rule has taken focus away from the potential for criminal charges for retaining known overpayments.  Section 1128B(a)(3) of the Social Security Act (42 U.S.C. § 1320a-7b(a)(3)) makes […]

Legal and Compliance Issues Impacting Medical Practices Using Laser Technology

Posted on April 7, 2017 by

Medical practices that routinely use laser technology are subject to some of the same legal issues as other types of practices. Use of lasers creates additional compliance issues and highlights certain compliance risk areas. Our special coverage issue contains articles on some of the legal issues impacting these practices. • Compliance Program Operation. All medical […]