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Please Click HerePosted on May 31, 2017 by Emilu E.C. Larson
As discussed in a previous blog, beginning on June 1, 2017, health care providers of services and suppliers wanting to voluntarily disclose actual or potential violations of the Stark Law must follow a new process finalized by CMS. Previously, health care providers and suppliers were able to submit a self-disclosure of an actual or potential […]
Posted on May 3, 2017 by Ruder Ware Alumni
In the first known case involving a wireless provider, a cardiology service provider agreed to pay a $2.5 million settlement based on the impermissible disclosure of unsecured electronic protected health information (ePHI). The company provides remote mobile monitoring of and rapid response to patients at risk for cardiac arrhythmias. The company disclosed to the Office […]
Posted on May 3, 2017 by Ruder Ware Alumni
Timeframes for Making Repayment to the Government The 60-day repayment rule adopted as part of the Affordable Care Act is a very strong arrow in the quiver of federal enforcement agencies. Under the 60-day rule a known overpayment can become a False Claim if it is not repaid or if a self-disclosure is not filed […]
Posted on May 3, 2017 by Ruder Ware Alumni
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 […]
Posted on April 19, 2017 by Ruder Ware Alumni
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 […]
Posted on April 19, 2017 by Ruder Ware Alumni
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 […]
Posted on April 12, 2017 by Ruder Ware Alumni
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 […]
Posted on April 11, 2017 by Ruder Ware Alumni
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 […]
Posted on April 11, 2017 by Ruder Ware Alumni
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 […]
Posted on April 7, 2017 by Ruder Ware Alumni
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 […]