Category Archives: Hospital Issues

AI Governance Risks: AI Ethics, Compliance, and Oversight Strategies

AI Ethics, Compliance, and Oversight Strategies AI governance risks explained: explore AI ethics, regulatory compliance, bias, privacy, security, transparency, accountability, and lifecycle AI oversight. AI governance encompasses the laws, policies, institutional responsibilities, technical standards, and organizational practices used to guide … Continue reading →

Posted in Artificial Intelligence, Compliance Issues, Governance, Hospital Issues, Wisconsin Health Laws | Comments Off on AI Governance Risks: AI Ethics, Compliance, and Oversight Strategies

OIG Advisory Opinions on Gainsharing Arrangements Since 2018

By Fisher, JD, CHC, CCEP Client Alert: OIG Advisory Opinions on Gainsharing Arrangements Since 2018 Introduction to Gainsharing Arrangements As hospitals, health systems, and physician groups continue to pursue value-based care strategies, gainsharing arrangements remain an important—but highly regulated—tool for … Continue reading →

Posted in Anesthesiologists, Clinical Integration, Fraud and Abuse, Health Care Contracting, Health Law Practice, Hospital Issues, Medicare and Medicaid, Medicare and Medicaid Reimbursement, Physician Contracting and Alignment, Physician Issues, Reimbursement & Payment Practices, Reimbursement Issues, Stark Law and Anti-Kickback Issues | Comments Off on OIG Advisory Opinions on Gainsharing Arrangements Since 2018

Podcast – Physician Verbal Orders Decoded

Legal Pulse: Healthcare Edition Welcome to Legal Pulse: Healthcare Edition, the podcast where we explore the intersection of law and medicine to keep you informed on the latest developments and trends. Episode 6 – Physician Verbal Orders Decoded Welcome to another … Continue reading →

Posted in Compliance Issues, False Claims Act, Fraud and Abuse, Hospital Issues, Legal Pulse Podcast, Medicare and Medicaid Reimbursement, Physician Issues, Reimbursement & Payment Practices | Comments Off on Podcast – Physician Verbal Orders Decoded

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 | Comments Off on Confidentiality of Substance Use Disorder Patient Records

Health Law Firm Opens Green Bay Office

By Fisher, JD, CHC, CCEP <   Health Care Attorney John Fisher Announces Virtual Legal Services for Green Bay, Menominee, Appleton, Oshkosh, and the Greater Fox Valley Attorney John Fisher, a health care lawyer with more than 30 years of … Continue reading →

Posted in Ambulatory Surgery Centers, Anesthesiologists, Antitrust in Healthcare, Behavioral Health, Clinical Integration, Consierge & Cash-Based Practices, Dental Practice Issues, Fraud and Abuse, Health Care Contracting, Health Law Practice, HIPAA - Health Information Privacy, Home Health, Hospital Issues, Long Term Care, Medical Staff Organization & Structure, Medicare and Medicaid, Medicare and Medicaid Reimbursement, Physician Contracting and Alignment, Physician Issues, Physician-Owned Hospitals, Radiology Issues, Reimbursement & Payment Practices, Self Disclosure Protocols, Stark Law and Anti-Kickback Issues, Telemedicine, Wisconsin Health Laws, Wisconsin Hospitals, Wisconsin Long Term Care, Wisconsin Physician Issues | Comments Off on Health Law Firm Opens Green Bay Office

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 | Comments Off on Physician Orders – Definition and Reimbursement Implications

Requirements Pertaining to Non-English Speaking Populations Medicare Health Plans

By Fisher, JD, CHC, CCEP Medicare Advantage and Part D Language Access Requirements for LEP Beneficiaries This article summarizes key Medicare Advantage and Part D requirements related to communication with non-English speaking and limited English proficient (LEP) populations. These requirements … Continue reading →

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MSSP Contracting Rules Create Operational and Revenue Risk for ACOs

For Health System and ACO Executives | Medicare Shared Savings Program Current as of: July 2026 Executive Takeaway: Current MSSP regulations at 42 C.F.R. § 425.116 make ACO contracting infrastructure an executive-level compliance and revenue issue. CMS requires ACOs to … Continue reading →

Posted in Clinical Integration, Compliance Issues, Hospital Issues, Managed Care Contracting, Medical Staff Organization & Structure, Medicare and Medicaid Reimbursement, Physician Issues | Comments Off on MSSP Contracting Rules Create Operational and Revenue Risk for ACOs

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 , , , , , | Comments Off on Unnecessary Inpatient Admissions Results in Hospital DOJ Settlement

Telemedicine Services Furnished in a Hospital – Telehealth Staff Privileges and Distant Site Credentialing –

Credentialing and Privileging in Telemedicine: CMS Regulations and Guidelines Understanding §482.22(a)(3) and Its Interpretive Guidelines for Hospitals Telemedicine has become an increasingly vital component of modern healthcare, allowing hospitals to expand access to medical services and expertise beyond their physical … Continue reading →

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