AI Governance Best Practices for AI Governance

Posted on January 7, 2026January 7, 2026 by admin

Overview of AI Governance Frameworks AI governance frameworks are essential for the consistent enforcement of organizational priorities throughout every phase of artificial intelligence initiatives. Through the implementation of standardized rules, procedures, and requirements, these frameworks p...

Using Artificial Intelligence to Detect Potential Health Care Fraud

Posted on October 30, 2025October 30, 2025 by admin

How AI Can Mitigate or Create Fraud and Abuse Risks in the Healthcare Industry The age of Artificial Intelligence is clearly upon us. Unless you are living in a cave it would be impossible not to understand that it will have an enormous impact on nearly every aspect of society, including the hea...

Concierge Medical Practice Definition and Overview

Posted on October 29, 2025October 30, 2025 by admin

Concierge Medicine Practice Membership Model and Enhanced Access A concierge medical practice typically operate on a membership basis, granting patients access to enhanced services and exclusive benefits in exchange for an annual or monthly fee. This model allows physicians to maintain smaller pa...

Senate Subcommittee (November 2023): Policy Considerations for AI in Health Care

Posted on December 9, 2024October 30, 2025 by admin

In November 2023, the Subcommittee on Primary Health and Retirement Security under the Senate Committee on Health, Education, Labor and Pensions held a hearing to examine the implications of artificial intelligence (AI) in health care. The hearing brought together lawmakers, technology experts, h...

Compliance Officer Authority and Resource Allocation

Posted on July 24, 2024October 29, 2025 by admin

The Department of Justice (DOJ) uses resource allocation as a key measure when evaluating the effectiveness of compliance programs. Allocating sufficient resources to the compliance function is foundational to any systematic compliance initiative and remains central as regulatory expectations evo...

Concierge Medicine Impact of Physician Ethical Obligations on Structure

Posted on July 13, 2022October 29, 2025 by admin

How Ethics Shape the Design and Delivery of Concierge Medicine Concierge Medicine Introduction Concierge medicine has emerged as a popular healthcare model, offering patients enhanced access, personalized care, and a variety of premium services in exchange for membership fees. While this approach...

Complying with HIPAA and Beyond during COVID-19

Posted on April 22, 2020October 29, 2025 by admin

Safeguarding Patient Health Information in an Emergency Situation Even in an emergency situation such as that presented by the COVID-19 pandemic, covered entities must continue to meet their obligations under federal and state laws protecting confidentiality of patient health care information, to...

Coronavirus Checklist for Nursing Homes and Hospitals

Posted on April 16, 2020October 30, 2025 by admin

Comprehensive Guide to Hospital Readiness and Infection Control Introduction The ongoing threat of coronavirus (COVID-19) requires hospitals to maintain rigorous preparedness and response plans. This detailed checklist is designed to help hospital administrators and healthcare teams ensure readin...

Proposed Revisions to the SAMHSA Regulations

Posted on September 23, 2019October 29, 2025 by admin

Impact on Communications Between Part 2 and Non-Part 2 Providers Introduction In our ongoing engagement with behavioral health and substance abuse programs, we maintain a vigilant focus on matters relating to patient record confidentiality governed by 42 CFR Part 2, commonly known as the SAMHSA r...

Congress Enacts the Eliminating Kickbacks in Recovery Act of 2018

Posted on June 13, 2019October 29, 2025 by admin

Congress has enacted a new Anti-Kickback law, known as the Eliminating Kickbacks in Recovery Act of 2018 (EKRA). This legislation specifically targets arrangements involving recovery homes, clinical treatment facilities, and laboratories. Congressional Intent and Purpose The primary intent behind...

Apply the 60-Day Repayment Rule to Medicaid Overpayments

Posted on May 30, 2019October 29, 2025 by admin

Overview of Overpayment Reporting and Repayment The Affordable Care Act (ACA) imposes specific requirements on individuals and entities that receive overpayments from designated government health programs. Under the ACA, any person who has received an overpayment from programs such as Medicare Pa...

The Incentive to Self Disclose False Claims Act Overpayments

Posted on May 28, 2019October 30, 2025 by admin

Proactive Compliance and Regulatory Oversight The Department of Justice (DOJ), in collaboration with other regulatory agencies, places a strong emphasis on the proactive monitoring of compliance by businesses. Recognizing that governmental resources alone are insufficient to uncover every instanc...

Deconstructing the “HIPAA Bias.”

Posted on May 22, 2019October 30, 2025 by admin

Understanding HIPAA and Its Interaction with State and Federal Confidentiality Laws HIPAA, the body of regulations designed to protect the confidentiality of patient health care information, has been highly effective in creating widespread awareness within health care facilities. Most staff membe...

DOJs New Evaluation of Corporate Compliance Programs – The Essence of Compliance

Posted on May 20, 2019October 30, 2025 by admin

The Criminal Division of the United States Department of Justice (DOJ) revised its Evaluation of Corporate Compliance Programs in April 2019. Initially introduced in 2017, this document provides prosecutors with structured guidance for investigations, charging decisions, and plea negotiations. Th...

New CMS Rules for Inpatient Rehabilitation

Posted on May 13, 2019 by admin

Well, it’s a start. New Medicare rules kicked in starting January 1, 2019 that are aimed at focusing less provider time on paperwork and more on patient care in inpatient rehabilitation facilities. Any change that reduces paperwork in this overregulated area is welcome, but the actual impac...

Telemedicine IT Donations and the Anti-kickback Statute OIG Opinion 18-03

Posted on October 29, 2018October 30, 2025 by admin

Overview of the OIG Advisory Opinion No. 18-03 The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued Advisory Opinion No. 18-03 regarding an arrangement in which a federally qualified health center look-alike (the “Provider”) proposes to donate informati...

CMS Proposes Rule to Ease Compliance Requirements

Posted on October 22, 2018 by admin

Last month, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule designed to, in CMS’s words, “relieve burden on healthcare providers by removing unnecessary, obsolete or excessively burdensome Medicare compliance requirements for healthcare facilities”. CMS esti...

OIG Opinion on Donation of Telehealth Equipment

Posted on September 5, 2018 by admin

A recent Advisory Opinion (Advisory Opinion 18-03) from the Office of Inspector General (OIG) of the Department of Health and Human Services addresses potential kickback issues involved in the donation of telehealth equipment. The OIG has issued opinions addressing technology donation in the pa...

Hospital Program for Free Support Services for Caregivers – Approved by OIG

Posted on August 30, 2018 by admin

A recent Office of Inspector General (OIG) advisory opinion approved a proposal under which a hospital has established a caregiver center that provides or arranges for free or reduced-cost support services to caregivers in the local community (Arrangement). The OIG, basing its opinion on the fa...

Ruder Ware Health Care and Compliance Attorney Receives Top Award

Posted on August 28, 2018October 30, 2025 by admin

Ruder Ware health care and compliance attorney John Fisher has received top recognition from JDSupra, a leading national legal blogging platform and resource site. Mr. Fisher received the 2018 Reader’s Choice Award from JDSupra in two separate categories, Health Care and Compliance. Mr. Fishe...