Natalia Mazina

SEPTEMBER 13, 2022

Earlier this year, a PBM denied several pharmacy audit appeals because pharmacies were not compliant with the provider manual when presenting their appeal paperwork. Namely, the additional documentation presented by the pharmacy lacked pharmacy NABP number, prescription number, and date of fill.

Due Diligence 52

Due Diligence 52

Hall Render

NOVEMBER 1, 2023

This Safe Harbor Policy (“Policy”) is aimed at incentivizing acquiring companies to identify and timely disclose misconduct discovered during the due diligence and post-acquisition integration process. Transactions that might have been abandoned or restructured due to the discovery of misconduct can now potentially move forward.

Due Diligence 40

Due Diligence Compliance Fraud 40

Verisys

FEBRUARY 6, 2025

This due diligence can significantly reduce malpractice claims risk and protect patients and institutions. Challenges in Managing Multiple Types of Credentialing Managing the various types of credentialing in healthcare presents significant challenges for administrators and compliance teams.

Licensing 52

Licensing Nurses Malpractice Compliance 52

HIT Consultant

MAY 4, 2023

She presents her findings to the team. Conduct due diligence when acquiring data-combing software, be transparent about research with staff and clients, and make sure to adhere to local and national policies. The last thing to keep in mind as businesses make greater plans for data collection and analysis is privacy measures.

Due Diligence 96

Due Diligence Nursing Homes Nurses Doctors 96

HIT Consultant

OCTOBER 13, 2021

Another aspect that makes API building for healthcare players an uphill task is that the FHIR API is presently limited in its usability and lags behind the FHIR adoption curve across the industry. As it is said, “you can have security without privacy, but you can’t have privacy without security.”.

Due Diligence 98

Due Diligence Health Insurance HIPAA Governance 98

Hall Render

JANUARY 13, 2025

In the present case, the FTC alleged that three oil companies, including XCL Resources, EP Energy and Verdun Oil, jumped the gun when they engaged in significant coordination and shifted substantial operational controls prior to the expiration of the HSR waiting period.

Due Diligence 40

Due Diligence Compliance Hospitals 40

HIPAA Journal

JUNE 5, 2023

The platform can be used for corporate communications, onboarding, training , and scheduling, and for conducting wellness checks with frontline workers – an engagement activity that is practically essential in the healthcare industry at present. For many Covered Entities, there are cheaper options.

HIPAA 89

HIPAA Due Diligence Compliance Licensing 89

Natalia Mazina

OCTOBER 5, 2022

Age or presentation of patient (e.g., If any of the above are present, the pharmacist must document how the red flags were resolved. The pharmacist, however, failed to document these inquires and we had no evidence (besides the pharmacist’s statement) that the pharmacy performed its due diligence in filling these scripts.

Due Diligence 52

Due Diligence 52

Hall Render

JANUARY 16, 2025

In the present case, the FTC alleged that three oil companies, including XCL Resources, EP Energy and Verdun Oil, jumped the gun when they engaged in significant coordination and shifted substantial operational controls prior to the expiration of the HSR waiting period.

Due Diligence 40

Due Diligence Compliance Governance Hospitals 40

HIT Consultant

DECEMBER 26, 2021

Direct patient care, however, presents the most striking reason to keep data and make it useful and immediately accessible; clinical decisions and medication management rely on the ability of each provider to understand the full patient.

Due Diligence 98

Due Diligence Compliance HIPAA Nurses 98

Healthcare Law Blog

FEBRUARY 2, 2023

Depending on the status of financial due diligence, the parties may wish to specify a closing cash target and working capital peg, and appropriate collars for purchase price adjustments if the closing working capital is above or below the peg (or outside of the range). Define purchase price adjustments.

Due Diligence 52

Due Diligence Fraud Compliance 52

Hall Render

JANUARY 11, 2023

The Tool presents developers of mobile health apps with a series of questions to help them understand which federal laws and regulations may apply. The Tool does not present a comprehensive list of laws and regulations that may apply to mobile health apps. Regulatory Landscape. Practical Takeaways.

Compliance 40

Compliance HIPAA FDA Due Diligence 40

Health Care Law Brief

NOVEMBER 9, 2021

In addition, hospitals and medical associations have generally expressed serious concerns about the Part II regulations, including regarding use of the QPA as the presumptive choice for establishing payment rates under these circumstances, as well as the administrative burden presented.

Medical Billing 75

Medical Billing Due Diligence Compliance Patient Satisfaction 75

YouCompli

MAY 24, 2023

You can use publicly available data to perform some initial due diligence. The key to compliance is ensuring that no remuneration is tied to past, present, or future referrals or business associated with federal healthcare programs. The CMS Open Payments website is a good place to begin.

Compliance Officers 52

Compliance Officers Compliance Doctors Due Diligence 52

Provider Trust

MAY 18, 2022

OIG may exclude the provider if certain circumstances regarding the ownership are present. Although an exclusion does not directly prohibit the excluded person from owning a provider that participates in Federal health care programs, there are several risks to such ownership.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

Verisys

FEBRUARY 6, 2025

By maintaining up-to-date records and conducting regular re-credentialing, healthcare organizations can demonstrate due diligence in ensuring their nursing staff meets all regulatory requirements. While essential for ensuring patient safety and regulatory compliance, it often presents several hurdles.

Nurses 52

Nurses US Department of Health and Human Services Licensing Regulatory Compliance 52

Verisys

JULY 13, 2023

Furthermore, speaker programs present serious optical and reputational risks since the speakers represent the pharmaceutical company. Anti-kickback statutes loom large over physician payments, while the off-label promotion of a medication during Q&A sessions is a challenge.

Compliance 52

Compliance Due Diligence Pharmaceutical Industry Fraud 52

AIHC

JUNE 22, 2022

Code of Federal Regulations (CFR) have, as a result, become the best standard for due diligence. Create a Credentialing Process Be clear on what you expect your providers to present to you for all background checks and scans as well as for payor enrollment purposes. CFR regulations (U.S. That way, you will be able to streamline.

Medicaid 52

Medicaid Medicaid Due Diligence Medicare 52

HIT Consultant

JANUARY 16, 2025

AI tools will enhance clinicians ability to process vast amounts of data, identify trends and present anomalies, ultimately making them more productive and effective in their diagnoses. The current landscape reveals a concerning statistic: merely 5.8% of eligible former smokers in America undergo CT-based lung cancer screening.

Public Health 111

Public Health Due Diligence COVID-19 Doctors 111

HIT Consultant

DECEMBER 28, 2023

Third-Party Vendor Assessment: Due diligence is required to thoroughly vet third-party vendors and their cybersecurity practices. Strong access control mechanisms should be implemented to prevent improper access to AI systems, underlying training models and infrastructure, and private patient records.

US Department of Health and Human Services 117

US Department of Health and Human Services Due Diligence Regulatory Compliance Compliance 117

Drug & Device Law

MARCH 5, 2024

Medical records, which most courts eventually recognize plaintiffs should have as part of their Rule 11 due diligence. Under the circumstances presented here, the Court concludes that the costs are properly taxable. Defendants who spend hundreds of thousands of dollars to obtain copies of plaintiff’s medical records.

Malpractice 52

Malpractice Due Diligence 52

Drug & Device Law

OCTOBER 24, 2023

Illinois decision in another case remanded from that MDL, the court in Gulledge denied plaintiff’s request to depose the sales reps who were present in the operating room at the time of her implant surgery and her revision surgery. Taking its cue from both the Pinnacle Hip Implant MDL and a N.D. DePuy Orthopaedics, Inc., LEXIS 54471 (N.D.

Due Diligence 59

Due Diligence Doctors 59

Drug & Device Law

FEBRUARY 14, 2022

Defendants would have been aware of such reports because each defendant had a corporate security group that would have tracked them as part of its due diligence. Presence at the time of the tortious conduct – “[T]hese defendants were not physically present at the attacks on plaintiffs.”

Governance 59

Governance Due Diligence Pharmaceutical Industry 59