Compliance
RSSArticles
-
$12.5 Million False Claims Act Settlement Shows Government Loss Not Required
A False Claims Act lawsuit involving alleged kickbacks for placing drugs on formularies has been settled for $12.5 million. The case is instructive because it shows the False Claims Act can apply even when the government has not lost money from the alleged violations.
-
Biden Administration Expected to Expand Enforcement; Pandemic Grants Targeted
The enforcement of white-collar crime laws in the healthcare sector is likely to expand under the Biden administration, particularly regarding fraud associated with the billions of dollars in grants Congress allocated to hospitals and other health providers for pandemic relief.
-
Closed Claims Study Shows Pain Management Risks as COVID-19 Contributes
An analysis of closed medical malpractice claims related to pain management identifies common areas of risk and reveals the COVID-19 pandemic has created new possibilities for liability. A top contributing factor in 90% of all closed claims was insufficient consent between the physician and the patient or family.
-
Changes to Stark Law Create Leeway for Inadvertent Errors
Proposed changes to the Physician Self-Referral Law (Stark Law) and other laws would give healthcare organizations more ability to avoid self-disclosure and refunds. The changes are expected to be finalized soon.
-
Physician Judgment Case Might Mean More Risk from FCA
Clinicians make judgment calls every day that do not always turn out to be correct, even when they are made in good faith. A recent court decision regarding the medical necessity of hospice care could put clinicians and hospitals at risk of False Claims Act allegations when judgment calls turn out wrong.
-
OCR Audit Findings Show Where to Focus HIPAA Compliance
Implementing a good security program with risk analysis, security practices, and risk mitigation can be a safe harbor from penalties.
-
Lessons Learned from Overturned $4.3 Million HIPAA Penalty
A covered entity’s victory over proposed penalties from the Department of Health and Human Services was good news for those responsible for HIPAA compliance, showing that good faith efforts and a willingness to fight the allegations can pay off.
-
Best Practices for Documenting Allergies
A good quality improvement project for 2021 would be to focus on bolstering the way the organization handles patients’ allergy histories.
-
AAAHC’s Allergy Benchmarking Study Highlights Inconsistencies
In a recent study, investigators found allergies sometimes were not verified or updated at each visit, there was a reliance on using the acronym NKDA (no known drug allergies), without references to other allergies or sensitivities, and overall allergic reaction documentation was inconsistent.
-
FWA Revisited: ‘Checking the Box’ and IO Responsibilities Under the Revised Common Rule
Revisions to the Common Rule took effect in 2018, but questions remain about how these changes have affected the Federalwide Assurance (FWA) and institutional responsibilities under the FWA.