AHLA Health Care Compliance Legal Issues Manual (Non-members)

ebook

By American Health Lawyers Association

cover image of AHLA Health Care Compliance Legal Issues Manual (Non-members)

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Authored by experts with years of health care compliance experience, this new edition integrates changes in regulation, trends in enforcement, and the reasoning of the courts to help you navigate emerging and unsettled areas of compliance risk, such as self-disclosure obligations, risks associated with opioid use, and the impact of statistical sampling.

Highlights of this edition include:

  • All new glossary of health care compliance terms, including key statutes, acronyms, governing agencies, and more
  • Expanded civil monetary penalty and exclusion authorities under 2017 final rules
  • Discussion of core elements of compliance programs for Medicare Advantage Plans and Part D Plans as established by federal regulations
  • Expanded whistleblower protections under federal and state law, false claims based on lack of medical necessity, materiality after Escobar, and recent enforcement activity
  • Expanded discussion of determinations of medical necessity, CMS review of medical necessity terminations, consequences, and appeals processes
  • Recent health information privacy and security developments, including new guidance, risks associated with innovative technologies, and trends in Health Insurance Portability and Accountability Act (HIPAA) enforcement activity
  • New chapters:

  • Chapter 1, Glossary of Key Terms
  • Chapter 10, The Relationship between Enforcement and Compliance
  • Chapter 17, Health Care Civil Rights and Nondiscrimination Under Section 1557 of the Affordable Care Act
  • Chapter 19, Behavioral Health
  • AHLA Health Care Compliance Legal Issues Manual (Non-members)