Physical Therapists and Compliance Programs: Do You Need One?

Physical Therapists and Compliance Programs: Do You Need One?

Physical therapists are among the targets of the federal government’s enforcement scrutiny within the healthcare sector. But does that mean that they’re mandated to maintain compliance programs? The Affordable Care Act of 2010 gave the Secretary of the U.S. Department of Health and Human Services (HHS) authority to require certain healthcare providers to have a compliance program as a condition of participating in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Although the HHS Secretary has not yet mandated

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Advanced Practice Registered Nurses Achieve Full Practice Authority in Illinois: Now What?

Advanced Practice Registered Nurses Achieve Full Practice Authority in Illinois: Now What?

With the passage of HB 313 in 2017, advanced practice registered nurses (APRN) now have full practice authority, free from mandatory oversight by a collaborating physician, in Illinois. Before they avail themselves of this new legal authority, APRNs should make sure they understand the details in HB 313 and pending regulations to implement the legislation, as well as the practical effects that full practice authority will have on their careers and practices. In late 2017, Illinois joined a growing number

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Cash-Pay Physical Therapy: Ensuring Compliance with the Medicare Mandatory Claims Submission Rule

Cash-Pay Physical Therapy: Ensuring Compliance with the Medicare Mandatory Claims Submission Rule

Just because you don’t accept Medicare at your physical therapy practice doesn’t mean that you’re not subject to some of its rules. Learn about the Medicare Mandatory Claim Submission Rule and its implications for your cash PT practice. One of the major draws of a cash-based physical therapy practice is avoiding the administrative hassles that come with participating in third-party payor programs, such as Medicare and Medicaid. But these practices should be cautioned: Even if they have no relationship at

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Celebrity HIPAA Violations: Lessons from the Jussie Smollett Incident

When healthcare providers gain access to celebrities’ medical records, HIPAA violations become newsworthy. CBS Chicago interviewed Erin Jackson of Jackson LLP to understand the actions of a hospital following a breach. In February 2019, television actor Jussie Smollett was charged with filing a false police report after allegedly staging his own assault. The stunning arrest created a national media firestorm, and as a result, Smollet became the subject of intense curiosity. Weeks later, the infamous case sent another shockwave through

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The Intersection Between Non-Solicitation and Patient Abandonment

The Intersection Between Non-Solicitation and Patient Abandonment

Common in employment agreements, non-solicitation clauses prohibit an employee from soliciting an employer’s clients, staff, and business contacts to do business with another firm or company. For healthcare providers looking to transition to a new practice or business, restrictions on the provider’s ability to solicit his or her patients to continue treatment at a new location can raise concerns that the provider will be liable for patient abandonment. By better understanding the limits of non-solicitation and patient abandonment claims –

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Healthcare License Compacts in Illinois: Where We Are, Where We’re Going

Healthcare License Compacts in Illinois: Where We Are, Where We’re Going

Can you cross state lines with your Illinois license? Increasingly, states are becoming more flexible with the geographic requirements they impose upon healthcare professionals.  We examine four healthcare compacts and their current status in Illinois: the medical, nursing, dental, and physical therapy compacts. Read on to learn about who supports them, who opposes them, and how they impact you. Over the past few years, many states have become more flexible on geographic licensing requirements for medical professionals, in part to

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The Pillars of Noncompetition Agreements in the Healthcare Industry: Illinois Law Considerations

The Pillars of Noncompetition Agreements in the Healthcare Industry: Illinois Law Considerations

Noncompetes typically limit an individual’s right to join or start a competitor business within a certain geographic range and for a designated period of time. Noncompetes are often supplemented by non-solicitation provisions, which restrict an individual from poaching a business’s clients, patients, or employees, and by confidentiality provisions. In recent years, noncompetition agreements – also known as “noncompetes” – have garnered significant attention among healthcare practices and businesses in Illinois. These agreements have a long history in the state’s healthcare

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What Orthodontists Need to Know About Illegal Referrals, Kickbacks, and Fee-Splitting Schemes

What Orthodontists Need to Know About Illegal Referrals, Kickbacks, and Fee-Splitting Schemes

To ensure legal compliance, orthodontists, like other healthcare professionals, should maintain a basic awareness of how these healthcare fraud, waste, and abuse laws may impact their practice. To this end, we summarize below the Stark Law, AKS, and related state laws, with an emphasis where applicable on Illinois law. Brace yourself for this number: Of the more than $2.8 billion in settlements and judgments that the U.S. Department of Justice (DOJ) obtained from civil cases involving fraud and false claims

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