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Read the latest news that impacts the healthcare compliance profession.
The proposed information blocking provider enforcement rule
The proposed enforcement rule for providers under the information blocking provisions of the 21st Century Cures Act was published in the Federal Register on November...
Valuable OIG compliance advice for new healthcare entrants
In November 2023, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the General Compliance Program Guidance (GCPG). The...
Mergers and acquisitions post-transaction considerations
Mergers and acquisitions (M&A) constantly occur in the healthcare industry. Organizations have varying levels of compliance involvement in the “due diligence” phase. During due diligence,...
It’s not research; it’s quality improvement
Organizations often struggle to navigate the fine line between research activities and quality improvement activities. This can be complicated by a lack of coordination between...
The compliance lessons in the wake of the Supreme Court decision in U.S. ex rel Schutte v. SuperValu, Inc.
The False Claims Act (FCA) permits private individuals to bring lawsuits in the name of the United States—called qui tam—against those they believe have defrauded...
Medicare Advantage in 2024—New rules, new loopholes
In the utilization management world, the adoption of CMS-4201-F—the new rule regulating many Medicare Advantage (MA) plan activities—was a game changer.[1] Like many new rules,...
The importance of healthcare due diligence in healthcare transactions
Due diligence is a vital step in all types of mergers, acquisitions, and other transactions, including making large investments in a company (collectively referred to...
Service animals in healthcare settings: Complying with laws and regulations
On September 14, 2023, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a proposed rule in the Federal...
HHS OIG General Compliance Program Guidance: An empowered and independent compliance function
Corporate Compliance & Ethics Week 2023 kicked off with a gift for healthcare and life sciences compliance practitioners by way of the U.S. Department of...
What providers need to know before billing for RPM services
In 2018, the Centers for Medicare & Medicaid Services (CMS) started reimbursing remote patient monitoring (RPM), a subset of telehealth, with the creation of the...