AHLA Health Care Compliance Legal Issues Manual (AHLA Members)

In this reorganized, and expanded edition of AHLA's bestselling, Health Care Compliance Legal Issues Manual, readers will find strategies for addressing the full scope of legal issues critical to health care compliance. The Manual addresses important topics such as what a compliance program is, how to conduct internal investigations, audit basics, what to consider prior to deciding on repayments and disclosures, substantive overviews of the False Claims Act, the Stark and Anti-kickback laws, health information privacy and security, issues in life sciences entities, tax compliance, and many others.

Publisher: AHLA

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Print Book: Softbound, 792 pages 5th Edition
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Authored by experts with years of health care compliance experience, this resource 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 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

EDITORS: Ann T. Hollenbeck, Karen Lovitch, Lester J. Perling, Cynthia F. Wisner

AUTHORS: Brooke Bennet Aziere, Amy Bailey, Douglas A. Blair, Elizabeth Callahan-Morris, Kyle E. Calvin, Elizabeth Carder-Thompson, Ritu Kaur Cooper, Thomas S. Crane, Gerald "Jud" E. DeLoss, Kyle Faget, Emily Black Grey, Gerald M. Griffith, Nancy Bonifant Halstead, Jake Harper, Kenneth E. Hooper, Gabriel L. Imperato, Kevin Kifer, Ronald H. Levine, Melissa L. Markey, Joseph Metro, Macauley Rybar, Alexandra "Allie" B. Shalom, Albert W. Shay, Harry R. Silver, E. John Steren, Drew Stevens, Sarah E. Swank, Teresa A. Williams, Amanda M. Wilwert, Howard J. Young

For full author bios, click here.

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Published April, 2019.

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