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Health Law and Compliance Update, 2018 Edition Health Law and Compliance Update, 2018 Edition

Health Law and Compliance Update, 2018 Edition

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Overview

The 2018 Health Law and Compliance Update, now in its 15th year, continues a publishing tradition that features national experts who address key developments in health care delivery, payment, and compliance. The authors include practical advice and analytical tools for use in organizational compliance programs, in addition to timely and thorough analysis of many substantive topics.

The 2018 Edition includes detailed coverage and expert insights on the following topics:

  • Risk Management, Internal Controls, and Regulatory Enforcement
  • Artificial Intelligence and the HIPAA Compliance Programs
  • Legal Compliance in Using Biospecimens in Research
  • Statistical Sampling: Use and Techniques Including RAT-STATS
  • The Increasing Importance of Data Analytics in Health Care Compliance
  • The 340B Program: Under the Microscope
  • Section 501(r) Likely to Stay, Even if the Affordable Care Act May Not
  • Recent Prosecutions of Doctors and Other Health Care Professionals Under the Travel Act
  • Fraud and Abuse

Note: Online subscriptions are for three-month periods.

Resources Highlight
Last Updated 11/16/2017
Update Frequency Updated annually
Product Line Wolters Kluwer Legal & Regulatory U.S.
ISBN 9781454884293
SKU 10045283-0002
Resources Highlight
Product Line Wolters Kluwer Legal & Regulatory U.S.
SKU 000000000010048337
Table of Contents

Chapter 1

YEAR IN REVIEW: John Steiner, Jordan Donnelly, Gabriel L. Imperato, Joseph Picone, Christopher Ideker

§ 1.01 Introduction

§ 1.02 New Medicare Exclusion Rules: How to Avoid Being Left Out

§ 1.03 Compliance and Audit; Shifting False Claims Act Liability to Financial

Auditors and Potentially Other Third Parties

Chapter 2

RISK MANAGEMENT, INTERNAL CONTROLS, AND REGULATORY ENFORCEMENT:

Louis Longo, Venson Wallin, Deepak Chaudhry, Brian Kirkpatrick

§ 2.01 Introduction

§ 2.02 Information Technology Risks Within Health Care

§ 2.03 The Relevance of IT Controls

§ 2.04 Definition of Risk and the Risk-Management Process

§ 2.05 Regulatory Enforcement

§ 2.06 Investigations

§ 2.07 Sample Compliance Checklist

Chapter 3

BEYOND THE BUZZWORDS: HOW ARTIFICIAL INTELLIGENCE IS TRANSFORMING DAY-TO-DAY PRIVACY, SECURITY, AND COMPLIANCE (AND WHAT THAT MEANS FOR PRIVACY PROFESSIONALS): Robert Lord, John Steiner

§ 3.01 Introduction

§ 3.02 Data Breach Landscape

§ 3.03 A Survey of Key Technologies that Intersect with the Compliance and Privacy Office

§ 3.04 Old Challenges and New Approaches to Privacy Monitoring

§ 3.05 Beyond the Buzzwords: Why New Technologies Matter to the Compliance and Privacy Office

§ 3.06 A New Framework: A Day in the Life

§ 3.07 Specific Regulations and Guidance Relevant to Privacy Teams and Privacy Technology

§ 3.08 Practical Considerations in Selecting a Privacy Monitoring Solution

§ 3.09 The Prognosis Is Good—What Comes Next Is Up to Us

Chapter 4

LEGAL COMPLIANCE IN USING BIOSPECIMENS IN RESEARCH: Kristen Rosati, Scott Bennett

§ 4.01 Introduction

§ 4.02 HIPAA

§ 4.03 The Common Rule

§ 4.04 FDA Regulations

§ 4.05 Genomic Data Sharing Policy of the NIH

§ 4.06 Putting It All Together: A Checklist for Biorepository Consents

Chapter 5

STATISTICAL SAMPLING; USE AND TECHNIQUES INCLUDING RAT-STATS: Christopher L. Haney

§ 5.01 Introduction

§ 5.02 Role and Uses of Sampling

§ 5.03 Terminology and Definitions

§ 5.04 Statistical Software and RAT-STATS

§ 5.05 Planning and Designing Sampling

§ 5.06 Executing and Interpreting the Sample Analysis

§ 5.07 Scrutinizing Opposing Analysis

§ 5.08 Relevant Cases

§ 5.09 Summary

Chapter 6

THE INCREASING IMPORTANCE OF DATA ANALYTICS IN HEALTH CARE COMPLIANCE: Paul R. DeMuro

§ 6.01 What Is Data Analytics?

§ 6.02 Health Information Technology

§ 6.03 Stakeholders and HIT

§ 6.04 The Transition from Fee-for-Service to Payment for Quality and Cost-Effectiveness

§ 6.05 Clinical Integration and Data Analytics

§ 6.06 Example of the Use of Data Analytics in Health Care

§ 6.07 Evolving HIT

§ 6.08 Implications for Compliance Professionals and the Compliance Office

§ 6.09 Summary and Implications for the Future

Chapter 7

THE 340B PROGRAM: UNDER THE MICROSCOPE: Richard P. Church, Joshua I. Skora, Ryan J. Severson, Corbin T. Santo

§ 7.01 Introduction to the 340B Program

§ 7.02 Orphan Drug Litigation Tests HRSA’s Authority to Regulate the 340B Program

§ 7.03 Omnibus Guidance Proposes Major Changes and Stirs Controversy

§ 7.04 The 340B Program in the Trump Administration and the 115th Congress

§ 7.05 Conclusion

Chapter 8

SECTION 501(r) LIKELY TO STAY, EVEN IF THE AFFORDABLE CARE ACT MAY NOT: Travis F. Jackson

§ 8.01 Introduction

§ 8.02 Understanding What Section 501(r) Requires

§ 8.03 Using Schedule H to the Form 990 to Self Audit

§ 8.04 Reviewing Sufficiency and Accessibility of Public Information

§ 8.05 Walking through the Hospital and Outpatient Clinics

§ 8.06 Engaging the Board of Directors Regularly

§ 8.07 Conclusion

Chapter 9

WHAT NOW? RECENT PROSECUTIONS OF DOCTORS AND OTHER HEALTH CARE PROFESSIONALS UNDER THE TRAVEL ACT: Carolyn Fitzhugh McNiven, Sonia Nguyen

§ 9.01 Introduction

§ 9.02 The Travel Act: Its Origin and Application to Acts of Commercial Bribery

§ 9.03 Recent Use of Travel Act Against Physicians and Other Medical Professionals

§ 9.04 State Statutes That Could Be Travel Act Predicates

§ 9.05 Conclusion

Chapter 10

FRAUD AND ABUSE UPDATE: Daniel K. Glessner, Nicole M. Thorn

§ 10.01 Introduction

§ 10.02 Primary Fraud and Abuse Statutes Overview

§ 10.03 When Fraud or Abuse Is Identified

§ 10.04 Critical Takeaways and Practical Implications

§ 10.05 The Compliance Program

§ 10.06 The Road Ahead

Table of Cases

Index

About The Experts
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