Legal and Regulatory Compliance

The ACA—and Other Healthcare Issues Confronting a New Congress

Republicans have promised to repeal the Affordable Care Act when Congress convenes in 2017, but they have other healthcare considerations to address, as well. 

Gail R Wilensky, PhD December 19, 2016

A Framework for Predicting the Trump Administration’s Health Policy Moves

Considered unpredictable by many, the policies of President-elect Donald Trump’s administration are beginning to take shape in health care.

Ken Perez December 19, 2016

MOON Form Approved

The MOON notice related to observation status was recently approved.

J. Stuart Showalter December 9, 2016

Ask the Experts: Physician Malpractice Insurance

Our hospital just acquired a physician group. What is our obligation to provide and/or pay for medical malpractice insurance?

HFMA November 16, 2016

Over the MOON about the NOTICE Act

Although many healthcare leaders applaud the fact that there is plenty of time to prepare for MOON requirements, there are lingering concerns, including limited patient education in the form and requirements for translating the form into other languages.

J. Stuart Showalter November 16, 2016

Addressing Challenges Presented by Financial Assistance Rules

Although the vast majority of hospitals have been working to implement IRS regulations for patient financial assistance, healthcare leaders should focus on potential problem areas because compliance with all the requirements is necessary to qualify for tax-exempt status.

J. Stuart Showalter October 12, 2016

Video: Critical Steps Toward 501(r) Compliance

Hospital financial assistance policies should be easily accessible by patients, and staff should be trained to explain the policies and assess patient eligibility.

HFMA October 12, 2016

High Court Decides False Claims Act Case

The Supreme Court ruled that “in some circumstances” hospitals’ implied certification of compliance with payment requirements may make them liable under the False Claims Act, but the decision’s reach is not as expansive as proposed by plaintiffs and the federal government.

J. Stuart Showalter August 4, 2016

False Claims Act Penalties are Rising

A recent increase in false claims penalties and a Supreme Court case placing the burden on healthcare organizations to be aware of payment requirements, necessitates that hospital compliance officers redouble efforts to prevent false claims.

J. Stuart Showalter August 4, 2016

New HIPAA Audits About to Begin

Both desk and on-site HIPAA audits will be performed, and every covered healthcare entity and business associate is eligible for an audit.

J. Stuart Showalter July 11, 2016
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