Avoiding Lawsuits for Wage and Hour Violations

Due to the highly technical language in the wage and hour laws and regulations, employers often find that they have unknowingly violated the Fair Labor Standards Act (FLSA). This can occur because employers have improperly classified an employee as exempt or because employers do not realize that certain time should be paid in full. Improperly classifying employees as exempt or failing to compensate nonexempt employees for all time worked can lead to costly lawsuits, audits, or enforcement actions by the Wage and Hour Division of the Department of Labor. This article discusses the most common FLSA exemptions and provides best practices to avoid liability under the FLSA.

Practice Consolidation: Forces Not of Nature, but of Government, Demographics, Economics, and Technology

The demand for healthcare services is increasing more rapidly than the supply of providers, while reimbursement levels ignore the free market law of supply and demand. The regulated healthcare environment in the United States fails to increase prices (i.e., reimbursement rates) as demand outstrips supply. Healthcare practitioners must find alternative methods in order to continue providing excellent patient care while at the same time maintaining an economically viable practice. Practice consolidation with the assistance of private equity healthcare investment is an extremely attractive solution to this imbalance.

Why Practices Should Screen Against Every State Exclusion List

Many physician practices believe it is enough to screen their employees against the Office of Inspector General's (OIG's) List of Excluded Individuals and Entities upon employment, and perhaps annually thereafter. Although this may have been an acceptable practice in years past, the OIG's Updated Advisory Bulletin on the Effect of Exclusions, the Centers for Medicare & Medicaid Services mandates to state Medicaid programs on screening, and the rules and regulations issued by the states themselves in response to these initiatives have broadly and significantly increased providers' exclusion screening obligations. This article discusses the nature of the expanded screening requirements for providers, and why the risks of noncompliance are too great to ignore.

Compliance Issues Facing Practices

Healthcare fraud enforcement has increased exponentially over the past few years. Practice groups have seen increased enforcement specifically from the federal government. It has never been more important to ensure everyone in your organization understands the various compliance issues and the risks they present. This article highlights the top compliance issues to help your practice groups understand the risks related to healthcare fraud. Once everyone in your organization understands these issues, you can work toward developing effective compliance programs to limit the risks.

Is your practice at risk for medical identity theft?

Medical identity theft has become increasingly prevalent. Medical practices need to take action and have policies and procedures in place to prevent data breaches. This will protect both the patient and the practice from medical identity theft.

Business associates gone bad: five tales of woe and ways to prevent them from happening to you

Liability for confidentiality of protected health information extends beyond the walls of a medical practice. Studies show a significant number of breaches occur via the actions or inactions of third-party entities/business associates. These business associates are trusted with patient information to assist a medical practice and can include collection agencies, third-party billing firms, transcription services, etc. Medical practices can be legally liable for the breaches of their business associates. This article provides an overview as to proper methods of retaining and monitoring business associates in an effort to minimize exposure from these firms.

Is the swiss health care system a model for the United States?

Both supporters and critics of the Patient Protection and Affordable Care Act (ACA) have argued that it is similar to Switzerland's Federal Law on Health Insurance (LAMal), which currently governs Swiss health care, and have either praised or condemned the ACA on the basis of this alleged similarity. I challenge these observers on the grounds that they overlook critical problems with the Swiss model, such as its inequities in access, and critical differences between it and the ACA, such as the roots in, and continuing commitment to, social insurance of the Swiss model. Indeed, the daunting challenge of attempting to impose the tightly regulated model of operation of the Swiss model on mega-corporations like UnitedHealth, WellPoint, or Aetna is likely to trigger no less ferocious resistance than a fully public, single-payer system would. I also conclude that the ACA might unravel in ways unintended or even opposed by its designers and supporters, as employers, confronted with ever-rising costs, retreat from sponsoring insurance, and workers react in outrage as they confront the unaffordable underinsurance mandated by the ACA. A new political and ideological landscape may then ensue that finally ushers in a truly national health program.

The health of healthcare, Part VI: Be prepared!

We who work in healthcare need to know our future. The following are virtually assured consequences of Patient Protection and Affordable Health Care Act: expansion of both the bureaucracy and its complexity; government restrictions on what physicians are allowed to do medically; more underinsured Americans; greater focus on outcomes; the death of private practice; more hospital closings; less available liability insurance; and an increase in medical tourism. We must--as the Boy Scouts advise--"Be Prepared"!

Your EHR license agreement: critical issues

This article discusses several key provisions and concepts in software license agreements for electronic health records. It offers insight into what physician practices can expect to find in their license agreements, as well as practical advice on beneficial provisions. The article examines contractual language relating to term and termination, technical specifications and support, and compliance with governmental programs.