This may not be obvious to people who do not keep track of the Federal Trade Commission (FTC)/Department of Justice antitrust enforcement policy, but an enforcement action has never been published involving an Accountable Care Organization (ACO) that participates in Managed Security Service Provi...

As health care attorneys we are often called upon to consider the antitrust implications in a variety of contracts and transactions.  For example, the establishment of clinically integrated health care networks requires consideration of potential price fixing and exclusionary issues.  The antit...

The state of Michigan has enacted a number of separate pieces of legislation to address the opioid epidemic.  Most of these laws are directed at controlling the prescribing relationship between a physician and a patient. Generally, Michigan requires a controlled substance license to prescribe co...

The Department of Justice (DOJ) recently announced the guilty plea of two individual alcohol and substance abuse treatment center owners for their participation in what the DOJ labeled a “multi-million dollar health care fraud and money laundering scheme.”  The two individuals owned a licens...

One of the reasons compliance officers and health care attorneys read fraud settlements is to identify issues the government is focused on.  The cases the government decides to pursue are very indicative of the areas of fraud enforcement they feel are important.  These are not the only issues t...

At a recent Health Care Compliance Association (HCCA) compliance institute, the Office of Inspector General announced it had launched a new resource portal focused on compliance issues.  A trip to the OIG’s web site, and sure enough, there is a brand spankin’ new compliance portal.  You can c...

We are often asked to advise clients regarding the scope and content of Health Insurance Portability and Accountability (HIPAA) policies and procedures that are required to be maintained.  HIPAA clearly requires health care providers, as “covered entities,” to maintain policies and procedure...

Conducting HIPAA Breach Risk Assessments The HIPAA rules relating to assessment of potential patient confidentiality breaches were changed in 2013.  Specifically, on January 17, 2013, the Office of Civil Rights released new regulations defining when a HIPAA breach is deemed to occur.  These reg...