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LEGAL LEANINGS: 6 Key Steps to Respond to a Health Care Investigation

By SETH WAXMAN
Dickinson Wright

The United States Department of Justice (“DOJ”) and state law enforcement agencies have robust teams investigating and prosecuting health care fraud. Law enforcement often uses advanced data analytics and algorithmic methods to identify newly emerging health care fraud schemes. DOJ also employs nine regional strike forces located throughout the country to bring together groups of prosecutors, FBI agents, and key administrative agencies to combat health care fraud. Critical time will be lost, and important steps may be missed if an organization waits until an investigation is underway to decide how to respond to a government investigation.

6 Steps for Responding to a Search Warrant

  1. Company policy

Health care [Read More]

LEGAL LEANINGS: 6 Key Steps to Respond to a Health Care Investigation2024-02-13T17:30:07-05:00

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Abortion Provider, Student Group Challenge Access Restrictions

A Michigan abortion provider and a pro-abortion rights student group filed a Michigan Court of Claims case challenging three abortion restrictions, including Michigan’s 24-hour waiting period.

Northland Family Planning Centers and Medical Students for Choice also challenge the dissemination of certain information to a patient before an abortion and prohibitions on the ability of advanced practice clinicians to perform abortions, according to the lawsuit filed recently.

“Through the RFFA, Michigan voters overwhelmingly declared that they will not tolerate paternalistic and medically baseless restrictions on abortion like those we are challenging in this [Read More]

LANSING LINES2024-02-13T17:26:01-05:00

There’s A New COVID-19 Variant And Cases Are Ticking Up. What Do You Need To Know?

By JULIE APPLEBY
It’s winter, that cozy season that brings crackling fireplaces, indoor gatherings — and a wave of respiratory illness. Nearly four years since the pandemic emerged, people are growing weary of dealing with it, but the virus is not done with us.

Nationally, a sharp uptick in emergency room visits and hospitalizations for COVID-19, influenza, and respiratory syncytial virus, or RSV, began in mid-December and appears to be gaining momentum.

Here are a few things to know this time around:

What’s Circulating Now?

The COVID virus is continually changing, and a recent version is rapidly climbing the charts. Even though it appeared only in September, the variant known as JN.1, a descendant of [Read More]

There’s A New COVID-19 Variant And Cases Are Ticking Up. What Do You Need To Know?2024-01-17T11:36:31-05:00

Michigan 10 Percent Behind Last Year’s Flu Shot Numbers

As of Dec. 2, Michigan was trailing behind last year’s administered flu shot numbers by more than 10 percent, which is a setback that’s caught the attention of the Michigan State Medical Society.

“The biggest risk would be to have a very severe flu season, with many severe illnesses requiring (hospitalization),” said Dr. M. Salim Siddiqui, MSMS president. “I think we all have a sense of what happens when our hospitals get overwhelmed by respiratory illness. For older patients and younger patients, there (would) be (concerns) about severe permanent complications and even death.”

During a recent roundtable discussion, lasting around 20 minutes, Siddiqui described the influenza vaccine as a way to avoid respiratory [Read More]

Michigan 10 Percent Behind Last Year’s Flu Shot Numbers2024-01-17T11:34:54-05:00

IN OUR VIEW: Keep The Momentum For Mental Health

By PAUL NATINSKY
Until recently, I never gave much serious thought to mental health. As a member of that latch-key, seat-beltless, hose-hydrating generation born in the late ‘60s, I thought of mental health as a refuge of the weak and excuse-seeking. Worse, at times I thought of those with severe mental health issues as hopeless institution dwellers beyond the help of healthcare professionals. Even as I gained experience as a healthcare reporter and health policy professional in the state legislature, I hated working on mental health issues.

That’s a tough truth to admit to for a healthcare publication editor and I’ll probably pay a price for that. But it is important to [Read More]

IN OUR VIEW: Keep The Momentum For Mental Health2024-01-17T11:31:59-05:00

ADELMAN’S ANALYSIS: COVID Boosters And Vaccines: Let Science Prevail!

By SUSAN ADELMAN, MD
Since the beginning of the COVID epidemic, most physicians have been struggling to do the right thing when it comes to treatment and prevention. Part of this was because, in the beginning, a terrifying complex of symptoms hit our patients fast, with high lethality, high transmissibility and distressing urgency. We worked hard, under pressure, to diagnose, to figure out immediate treatments, to devise prevention strategies, to understand new vaccines, and, eventually, boosters. Now we have a great deal of information, but most of us in the medical profession still are hard-pressed to be confident in our recommendations about vaccines and boosters for all age groups. Meanwhile, some politicians, [Read More]

ADELMAN’S ANALYSIS: COVID Boosters And Vaccines: Let Science Prevail!2024-01-17T11:02:49-05:00

ON POINT WITH POs: A Much Needed Checklist Of Steps To Take When A Practicing Physician Dies

By EWA MATUSZEWSKI
When a practicing physician dies, there is not only intense grief, but an entire gamut of professional details that require immediate attention. I recently faced this personal challenge and was admittedly adrift in confronting first and subsequent steps. Perhaps I should have known them already—but some of the medical associations and health plans I reached out to didn’t either. The question? Where is the checklist to guide me through the “un-credentialing” of a physician?

With the risk of identity theft high, it is imperative that no enterprising thief access physician credentials for nefarious purposes. Here is what I learned by creating my own checklist for steps that must be [Read More]

ON POINT WITH POs: A Much Needed Checklist Of Steps To Take When A Practicing Physician Dies2024-01-17T11:00:32-05:00

COMPLIANCE CORNER: Medicaid Coverage Expanded By MDHHS To Include Community Health Worker Services

By SHEA MACE
Wachler & Associates, P.C.

On December 7, 2023, MDHHS announced that community health worker services now will be covered by Medicaid. The new policy is effective January 1, 2024, and chiefly applicable to the Medicaid Fee-for-Service (FFS) program. Medicaid Health Plans (MHPs) and Integrated Care Organizations (ICOs) must also comply by offering the full range of services described within the policy, although they may provide additional services beyond those specified and may develop review and prior authorization criteria different than Medicaid requirements.

CHW Overview

Community health workers (CHWs) are non-licensed but trained public health providers who have distinct knowledge and appreciation of the community they serve. They function as a liaison [Read More]

COMPLIANCE CORNER: Medicaid Coverage Expanded By MDHHS To Include Community Health Worker Services2024-01-17T10:54:30-05:00

LEGAL LEANINGS: A State-Based Cure – Interested Government Agency J-1 Waivers For Physicians

By KATHLEEN CAMPBELL WALKER
Recently, the president of the American Medical Association, Jesse M. Ehrenfeld, MD, stated in a national address that the physician shortage long-feared is here and that “It’s an urgent crisis…hitting every corner of this country—urban and rural—with the most direct impacting hitting families with high needs and limited means… Ninety percent of counties in the U.S. are without a pediatric ophthalmologist. Eighty percent are without an infectious disease specialist.”

All areas of the country rely in part on foreign medical graduate (FMG) physicians, who may be required to serve in qualifying health professional shortage areas (HPSAs) or medically underserved areas (MUAs) to transition to a career as [Read More]

LEGAL LEANINGS: A State-Based Cure – Interested Government Agency J-1 Waivers For Physicians2024-01-17T10:52:03-05:00

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Passive Renewals Helping Medicaid Redetermination Process

With Michigan’s post-pandemic Medicaid redetermination process well underway, the Department of Health and Human Services has stayed busy contacting Medicaid recipients to inform them of their redetermination requirement. But, in some cases, an automatic or passive renewal is easing DHHS’ workload.

Nicole Hudson, DHHS senior advisor on special projects, explained the redetermination process that started after three years of pandemic-prompted auto-renewals for Medicaid. It was accompanied by a significant increase in the state’s Medicaid population and an almost 35% increase in Michiganders on Medicaid.

Over 3.2 million Michiganders were covered by Medicaid in May [Read More]

LANSING LINES2024-01-17T10:44:20-05:00
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