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Wisconsin Health Law Posts
- The Physician Board Member – Meeting Your Responsibilities as a Director
- Concierge Medicine Agreements – Five Key Contract Clauses for Medical Practices
- Telehealth Membership Platforms: A Provider Compliance Guide
- Medicare Opt-Out – A Make-or-Break Decision for Concierge Physicians
- Hybrid Concierge Models – Why Popularity Comes With Compliance Risk
- Cash-Based Clinics – A Regulatory Landscape More Complex Than It Appears
- State Spotlight: Wisconsin, Illinois, and Michigan — Three Distinct Regulatory Environments
- Understanding HIPAA and Its Interaction with State and Federal Confidentiality Laws
- Concierge Medicine Legal Guide: Key Compliance and Business Issues for Physicians
- Direct Primary Care (DPC) vs. Concierge Medicine: A Regulatory Comparison
- Physician Autonomy in the Value-Based Care Era: Legal and Operational Priorities for Health Care Providers
- Telehealth and Concierge Medicine – A Strong Fit with Complex Rules
- Preparing for Certification Surveys at Ambulatory Surgery Centers
- Podcast – ASC 2030: The New Playbook
- Podcast – ASC Life Safety Code Decoded
- Podcast – ASC Survey Ready Now
- Podcast – QAPI: Build It Right
- Podcast – Closing Infection Control Gaps
- Podcast – ASC Governance Accountability
- ACO Primary Care Exclusivity Requirement – Not As Broad As Some Believe
Categories
- Accountable Care Organizations
- Ambulatory Surgery Centers
- Anesthesiologists
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- Behavioral Health
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- Compliance Issues
- Consierge & Cash-Based Practices
- COVID-19 Resources
- Dental Practice
- Dental Practice Issues
- False Claims Act
- Fraud and Abuse
- Governance
- Health Care Contracting
- Health Care Legislation
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- Legal Pulse Podcast
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- Physician Contracting and Alignment
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- Reimbursement & Payment Practices
- Reimbursement Issues
- Self Disclosure Protocols
- Stark Law and Anti-Kickback Issues
- Telemedicine
- Uncategorized
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- Wisconsin Health Laws
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Category Archives: Uncategorized
New Memorandum On Telehealth In Mental Health and Substance Abuse Programs
By John Fisher, JD, CHC, CCEP Wisconsin Updates Telehealth Guidance for Mental Health and Substance Abuse Programs Client Alert: August 11, 2015 What Changed? The Wisconsin Division of Quality Assurance (DQA) has issued updated guidance on the use of telehealth … Continue reading
Posted in Department of Health Services, Telemedicine, Uncategorized, Wisconsin Government, Wisconsin Health Laws, Wisconsin Hospitals, Wisconsin Long Term Care, Wisconsin Physician Issues
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Concierge Medicine Article Series | The Anti-kickback Statute in Concierge and Cash-based Medical Practices
By John Fisher, JD, CHC, CCEP The Concierge and Cash-Based Medical Practice Article Series explores the evolving landscape of healthcare delivery models that prioritize patient-centered care, transparency, and direct financial relationships between patients and providers. Through this series, readers will … Continue reading
Posted in Consierge & Cash-Based Practices, Fraud and Abuse, Medicare and Medicaid, Physician Issues, Reimbursement & Payment Practices, Stark Law and Anti-Kickback Issues, Telemedicine, Uncategorized
Tagged anti-kickback statute, Concierge Clinics, Concierge Medicine, direct primary care, Telemedicine, wisconsin health lawyer
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Confidentiality of Substance Use Disorder Patient Records
By Fisher, JD, CHC, CCEP 2018 SAMHSA Final Rule: Clarifying Part 2 Confidentiality Requirements On January 3, 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) published final regulations updating 42 CFR Part 2, the federal confidentiality rules governing … Continue reading
Posted in Behavioral Health, HIPAA - Health Information Privacy, Hospital Issues, Uncategorized
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Physician Orders – Definition and Reimbursement Implications
By Fisher, JD, CHC, CCEP Physician Order Compliance: Definitions, Documentation, and Medicare Payment Risk Physician order compliance is a practical issue for health care providers, billing teams, and compliance professionals because physician orders help direct patient care, support medical necessity, … Continue reading
Posted in Compliance Issues, Health Law Practice, Hospital Issues, Medicare and Medicaid, Medicare and Medicaid Reimbursement, Physician Issues, Reimbursement & Payment Practices, Uncategorized
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The Impact of a Physician’s Ethical Obligations on Concierge Program Structure
As with other types of practice arrangements, concierge medicine arrangement require attention to the ethical implications. Physicians who enter these arrangements will want to assure that the structure and operation of the concierge practice does not violate any ethical principles. … Continue reading
Posted in Consierge & Cash-Based Practices, Physician Issues, Telemedicine, Uncategorized
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Applying Section 1557 Discrimination Rules to Employer Sponsored Health Plans
By Fisher, JD, CHC, CCEP Section 1557 Final Rule: Implications for Covered Entities and Employer-Sponsored Health Plans April 2024 Executive Summary The U.S. Department of Health and Human Services (“HHS”) finalized regulations implementing Section 1557 of the Affordable Care Act … Continue reading
Posted in Accountable Care Organizations, Compliance Issues, Health Care Legislation, HIPAA - Health Information Privacy, Reimbursement Issues, Uncategorized
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DOJ Skilled Nursing Facility Settlement Involving Rehab – Highest Ever
By Fisher, JD, CHC, CCEP Skilled Nursing Facility False Claims Act Settlement Signals Continued Scrutiny of Therapy Billing Client Alert | Health Care Enforcement and Compliance Skilled nursing facility operators should continue to pay close attention to how rehabilitation therapy … Continue reading
Posted in Compliance Issues, False Claims Act, Fraud and Abuse, Long Term Care, Uncategorized, Wisconsin Long Term Care
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When may a Referral be Mandated for Employed Physicians under the Stark Law?
By Fisher, JD, CHC, CCEP When Can an Employer Require Referrals from Employed Physicians Under the Stark Law? The Stark Law, also known as the Physician Self-Referral Law, generally prohibits physicians from referring Medicare or Medicaid patients for designated … Continue reading
Posted in Fraud and Abuse, Physician Issues, Stark Law and Anti-Kickback Issues, Uncategorized
Tagged referral requirement. employed physician, stark law
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Unnecessary Inpatient Admissions Results in Hospital DOJ Settlement
Hospital Inpatient Admission Fraud: False Claims Act Risks for Unnecessary Hospital Admissions Quick Answer: What Is Hospital Inpatient Admission Fraud? Hospital inpatient admission fraud occurs when a hospital allegedly bills a federal health care program for inpatient care that was … Continue reading
Posted in Compliance Issues, Fraud and Abuse, Hospital Issues, Physician Issues, Self Disclosure Protocols, Uncategorized
Tagged admissions criteria, DOJ settlements, Fraud Settlement, fraudulen admissions, Hospital fraud, unnecessary admissions
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Whistleblower Settlements Increase Compliance Risk for Providers
By Fisher, JD, CHC, CCEP Recent Fraud Settlements Highlight Whistleblower and Compliance Risks for Health Care Providers Health care compliance officers and counsel often review fraud settlements to identify the enforcement priorities receiving government attention. Although settlement announcements do not … Continue reading
Posted in Fraud and Abuse, Medicare and Medicaid, Stark Law and Anti-Kickback Issues, Uncategorized
Tagged compliance risk, whistleblower, whistleblower risk
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