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98 search results for: Rachel Rose

41

Healthcare and Technology Negotiations

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Catherine Short converses with Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX and Bruce J. Lynskey, Co-Founder at ePrevenir, on the topic of “Negotiations in Healthcare and Technology.” Negotiating occurs in every facet of business and law. From contractual negotiations through settlement negotiations, it is a delicate dance. There are a variety of classic negotiation techniques, which include extreme posturing and “anchoring”. Healthcare and cybersecurity present unique challenges because of the looming exposure to a government investigation and either a civil and/or criminal action, even if a settlement is reached between two private parties. Here we will discuss approaches when negotiating contracts, settlements, and other items, which arise in healthcare and the cybersecurity industries.

42

DMEPOS – CMS Compliance and Requirements Updates

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Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely subject for us. Durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) includes an “entity or individual, including a physician or a Part A provider, which sells or rents Part B covered items to Medicare beneficiaries.” There are special payment rules associated with DMEPOS. DMEPOS products have to meet quality standards, DMEPOS suppliers need to be accepted by Medicare to participate (similar to providers), and are subject to fraud, waste, and abuse laws. The purpose of this webinar to provide an overview of participation and quality requirements, relay the latest compliance and requirements updates, and address False Claims Act cases involving DMEPOS companies.

43

Fraud, Healthcare, COVID-19 and the False Claims Act

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Catherine Short speaks with Shauna Itri, Partner at Seeger Weiss LLP on the topic of “Fraud, Healthcare, COVID-19 and the False Claims Act.” A whistleblower or qui tam action can provide financial rewards to individuals who have information that a company/individual has committed fraud. The primary statutes under which this relief may be sought are the federal and state False Claims Acts (“FCAs”). In addition to the FCAs, there are other statutes which apply to tax fraud, securities fraud, and in California, fraud on private insurance companies. This episode will provide an overview of the False Claims Acts, the knowledge and skills to be able to recognize a potential whistleblower case, and understand the unique procedures utilized in filing whistleblower cases/tips. We will also delve into recent trends in cases brought (or that could be brought) under the False Claims Act including cases involving mined data and potential fraud related to COVID-19.

44

The No Surprises Act – What You Need to Know: Audio Version of the Webinar

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Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely subject for us. Effective January 1, 2022, the No Surprises Act has implications for patients, providers, and insurance companies alike. The impetus behind the legislation, as well as the regulations, is to prevent patients from receiving bills for certain services that were performed or delivered by providers out of their plan’s network. The scope is limited and providers and plans alike need to take steps to understand the appeal process when a payment or claim is challenged. The purpose of this presentation is to provide a brief overview of the evolution of the United States’ healthcare system and its relevance to the No Surprises Act. From there, the No Surprises Act and regulations will be explained, along with the appeal process. Finally, compliance tips will round out the presentation.

45

What You Need to Know about The No Surprises Act

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Catherine Short speaks with Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “The No Surprises Act – What You Need to Know.” Effective January 1, 2022, the No Surprises Act has implications for patients, providers, and insurance companies alike. The impetus behind the legislation, as well as the regulations, is to prevent patients from receiving bills for certain services that were performed or delivered by providers out of their plan’s network. The scope is limited and providers and plans alike need to take steps to understand the appeal process when a payment or claim is challenged. The purpose of this episode is to provide a brief overview of the evolution of the United States’ healthcare system and its relevance to the No Surprises Act. From there, the No Surprises Act and regulations will be explained, along with the appeal process. Finally, compliance tips will round out the show.

46

What you need to know about the No Surprises Act

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Enacted in late 2020 as part of the Consolidated Appropriations Act of 2021 with an effective date of Jan. 1, 2022, the No Surprises Act (NSA) underscores its primary purpose is to protect patients from surprise medical bills when receiving certain services from – emergency services, non-emergency services from nonparticipating providers at participating facilities, and air ambulance service from nonparticipating providers. (86 Fed. Reg. 36872 (Jul. 13, 2021)).

47

The No Surprises Act – What You Need to Know

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Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely subject for us. Effective January 1, 2022, the No Surprises Act has implications for patients, providers, and insurance companies alike. The impetus behind the legislation, as well as the regulations, is to prevent patients from receiving bills for certain services that were performed or delivered by providers out of their plan’s network. The scope is limited and providers and plans alike need to take steps to understand the appeal process when a payment or claim is challenged. The purpose of this presentation is to provide a brief overview of the evolution of the United States’ healthcare system and its relevance to the No Surprises Act. From there, the No Surprises Act and regulations will be explained, along with the appeal process. Finally, compliance tips will round out the presentation.

48

FAQ: Ever Shifting Vaccination Landscape

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The COVID vaccination landscape, both within the healthcare sector and at other businesses, is in flux. It’s challenging to keep up with current requirements and recommendations. At First Healthcare Compliance we strive to serve as a trusted resource and provide answers to frequently asked questions.

49

The Intersection Between HIPAA, Cybersecurity, & Fraud, Waste and Abuse

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Rachel V. Rose, JD, MBA, a Principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents The Intersection Between HIPAA, Cybersecurity, & Fraud, Waste and Abuse at the  Virtual HIPAA Privacy and Security Summit 2021 on November 18. Ms. Rose has a unique background, having worked in many different facets of healthcare, […]