December 15, 2022
Volume XII, Number 349
December 15, 2022
– Beyond Backpay: Labor Board Adds Extra Compensation to Employees in ‘…by: Jonathan J.Spitz and Richard F.Vitarelli
– Special Delivery: NLRB Returns to Obama-Era Standard to Limit…by: Michael J.
Lebowich and Joshua S.Fox
– Recent Developments to the 340B Drug Pricing Program [PODCAST] by: Victoria K.Hamscho and Andrew D.
Ruskin
– Festive NLRB Provides Holiday Gifts to Unions/Employees by: Robert E.Entin
– Third Circuit: Whistleblowers Are Not Shielded From Discipline for…by: Steven J Pearlman and Pinchos (Pinny) Goldberg
– Psychedelic Drugs – Easing the Regulatory Hurdles for Development by: Lauren P.Carboni and Devaki Patel
– CFPB and State Regulators Hone in on Interest-Bearing Crypto Accounts by: Moorari Shah and A.J.S.Dhaliwal
– U.S.Supreme Court to Decide Whether Appeal of Denial of Motion to…by: William Robert Gignilliat, IV and Samia M.
Kirmani
– OCC Revises Policies and Procedures for Civil Money Penalties by: Moorari Shah and A.J.S.Dhaliwal
– Several New Group Health Plan Reporting Deadlines Are Approaching –…by: Nick J.
Welle and Hannah R.Demsien
– CMS Includes MAOs in Data Exchange and Prior Authorization…by: Christine M.Clements and Sheela Ranganathan
– Abortion-Related Time Off After Dobbs: How the FMLA and Other Laws…by: Frank C.
Morris, JR and Susan Gross Sholinsky
– Battle Lines Drawn on Electric Vehicle Tax Credit Specifics by: William Ball
– Emerging Threats: Cyber Attacks and Side-Channel Evolution by: Iliana L.Peters and Colin H.Black
– ’Tis the Season for California’s 2023 Legislative Update: Employer…by: Vanessa C.Krumbein and Rana Ayazi
– Guide to Creating a Corrective Action Plan Template by: Dr.
Nick Oberheiden
– Ten Environmental and Energy Issues to Watch in 2023 by: J.Michael Showalter and Amy Antoniolli
– Treasury Announces a Second Application Round for ECIP Investments by: Neil E.Grayson and Robert Klingler
– S.D.N.Y.Voids ERISA Plan’s Arbitration Provision by: Joseph E Clark and Daniel B.Wesson
– Michigan Minimum Wage and Paid Leave Update: Agency Guidance and the…
by: Emily M.
Petroski and Allan S.Rubin
– NLRB Reinstates “Micro Unit” Standard Making it Easier for Unions to…by: James J.La Rocca and Robert T.
Dumbacher
– Love and Marriage: How the Respect for Marriage Act Affects Employers…by: J.William Manuel and Anne R.Yuengert
– DHS Issues Guidance on Additional H-2B Temporary Nonagricultural…by: Jessica Feinstein
– 12 Days of CRM: Day 1 – How to Measure CRM Success by: Christina R.Fritsch JD
– Staff Says Some Non-GAAP Financial Disclosures Are Beyond Redemptive…by: Keith Paul Bishop
– A Direct Hit: NLRB Expands Make-Whole Remedies to Cover All “Direct…by: Michael J.
Lebowich and Joshua S.Fox
– NLRB Dramatically Increases Liability for Unfair Labor Practices with…by: Adam C.Abrahms and Neresa A.De Biasi
– False Claims Act: Prediction on Supreme Court Ruling on Government…by: Lori A.Rubin and Pauline R.Wizig
– Proxy Season Greetings: ISS and Glass Lewis Announce Policy Updates…
by: Colleen Hart and Andrea S Rattner
– Supreme Court Declines to Clarify FCA Pleading Standard by: Scarlett Singleton Nokes and Virginia C.Wright
– Full Speed Ahead: District Court Entitled to Explore Litigation…by: Amol Parikh
– Economically Motivated Adulteration in Honey by: Food and Drug Law at Keller and Heckman
– China Announces New Management Measures for Food-Related Products by: David J.Ettinger and Eric Gu
– Ratings Agencies Increase Focus on “Green Ratings” by: Jacob H.Hupart
– Increased Federal Attention to Skilled Nursing Facility Compliance…by: Anne M.Murphy and Rachel Hold-Weiss
– European Commission to Start Adequacy Decision Adoption Process for…by: Hunton Andrews Kurth’s Privacy and Cybersecurity
– Applying Collateral Estoppel in IPRs by: Alexandra Cavazos, PhD
– Appellate Court Addresses How Much Information Employee Must Submit…
by: Tasos C.Paindiris and David Mohl
– Improving Liquidity Through Real Estate Sale and Leaseback…
by: Simone Wijngaard and Alexander van Hövell
– The Ultimate Lawyer Time Off Checklist by: Kamron Sanders
– PTO Announces Cancer Moonshot Expedited Examination Pilot Program by: Bernard P.Codd
– Do Law Firms Use HubSpot? by: CRM News and Updates, Lawmatics
– Litigation Minute: Year in Review—Trending Topics Across the 2022…
by: Lindsay Sampson Bishop and Jacquelyn S.Celender
– The State of ESG Reporting in Australia by: Clive Cachia and Adam Levine
– Supreme Court to Hear Case on Whether Lawsuits are Stayed During…
by: Ron Chapman, Jr.and Zachary V.
Zagger
December 14, 2022
– Certain Green Cards Getting 24-Month Extensions as USCIS Deals With…by: Michael H.Neifach
– Ankura CTIX FLASH Update – December 13, 2022 by: Ankura Cyber Threat Investigations and Expert Services
– Australia: Climate and Sustainability-Related Financial Disclosure…by: Jim Bulling
– Ankura CTIX FLASH Update – December 9, 2022 by: Ankura Cyber Threat Investigations and Expert Services
– New Washington State Guidance A Reminder That More State Pay…
by: Aaron Vance
– Washington Supreme Court Affirms Ecology’s Authority to Bypass…by: Erika H.Spanton and Allyn L.Stern
– NLRB Unleashes New Damages Against Labor Law Violators by: Mark J.
Neuberger
– Illinois Appellate Court Weighs in on Biometric Data Policies by: David M.Poell and Kari M.Rollins
– FTC Issues Green Guides Questionnaire by: Phyllis H.Marcus
– Traveling for the Holidays: Planning for Successful International…by: Ann H.
Lee and Michael J.Bonsignore
– NYC Council Considering Proposal To Significantly Limit At-Will…by: Evandro C Gigante and Joseph C O’Keefe
– Webinar Recording: Navigating Today’s Privacy Compliance…
by: Cynthia J.Larose
– Pennsylvania Takes Emergency Action to Regulate Conventional Oil…by: David J.
Raphael and Brianna K.
Edwards
– A Look At The Upcoming European Unitary Patent And Unified Patent…by: Angela B.Freeman, M.S.and Rory P.
Pheiffer
– Massachusetts Unveils New Workplace Poster, Notifications for…by: Rachel Reingold Mandel and Ashley Prickett Cuttino
– US Executive Branch Update – December 14, 2022 by: Stacy A.Swanson
– Michigan Court of Appeals Hears Argument on the Adopt and Amend…by: Luis E.
Avila and Maureen Rouse-Ayoub
– California Wage and Hour Issues for Employers to Watch in 2023: Is My…by: Karen E.Wentzel and Michael W.Kelly
– AML Bill Key to Busting Russian Oligarchs by: Stephen M.
Kohn and Grace Schepis
– SEC and CFTC Whistleblower Programs Reveal Continued Success…
by: Jason Zuckerman and Matthew Stock
– Prices Keep Rising: Labor Board Significantly Expands Remedies…by: David J.Pryzbylski and Aaron Vance
– More on Understanding the Medicare Overpayment Appeals Process by: Kendall R.
Walker and Courtney G.Tito
– New York State Provides Protection for Use of Leaves of Absence by: Jonathan A.Wexler
– US Executive Branch Update – December 13, 2022 by: Stacy A.Swanson
– Looking Ahead to 2023: Pay Transparency Developments by: Allan S Bloom and Evandro C Gigante
– What Does 2023 Hold for California COVID-19 Supplemental Paid Sick…by: Benjamin A.Tulis
– AND ANOTHER ONE! TCPA CLASS DISCOVERY LIMITED: Third Party Subpoena…
by: Jenniffer Cabrera
– Reminder: New Tax Forms for Retirement Plan Payment Withholding…by: Jeffrey M.Holdvogt and Diane M.Morgenthaler
– Ninth Circuit Answers Lingering Question on Scope of ‘Autodialer…by: Joseph C.
Wylie II and Nicole C.
Mueller
– Speak Out Act Takes Effect, Enhanced Data Privacy Obligations for…by: George Carroll Whipple, III
– Preparing for New SBA Certification Requirements for Veteran-Owned…by: Erin L.Toomey and Frank S.
Murray
– California Starts Mandating Employee Bereavement Leave in 2023 by: Paul R.Lynd
– HHS Bulletin: Covered Entities’ Disclosure of PHI Collected via…by: Ryan P.Blaney and Danielle L.
Brooks
– When 2 Minus 1 Still Equals 2: Combining Lots in a Planned Community by: Dana M.Lingenfelser and Kristin D.Mitcham
– GREAT LEGAL WORK: TCPA Defendant Wins a HUGE Certification Victory…by: Eric J.Troutman
– 401(k) Compliance Check #12: Don’t Borrow Trouble – Correcting…
by: Belinda S.Morgan
– FDA Published Food Safety Culture Literature Review by: Food and Drug Law at Keller and Heckman
– Does a business have to provide a privacy notice directly to a…by: David A.Zetoony
– New Privacy Enforcement Act Commences in Australia by: Cameron Abbott and Rob Pulham
– NYC Delays Enforcement of Automated Employment Decision Tools Law to…by: Lindsay Colvin Stone
– U.S.Department of State to Update Design on Nonimmigrant and…by: Ashley K.
Kerr
– Cannon Fire: Newly-Famous Judge Stays All Discovery in TCPA Class…by: Eric J.Troutman
– EPA Announces Proposed RFS for 2023-2025, Will Hold Public Hearing in…by: Lynn L.Bergeson and Carla N.
Hutton
– Why Do Law Firms Need CRM? by: CRM News and Updates, Lawmatics
– This California Rule by: Keith Paul Bishop
– Unintended Consequences: Legal Compliance Concerns With Long-Term…by: Amber K.Dodds and Robert S.Nichols
– UK Parliament Considers Retained EU Law (Revocation and Reform) Bill…by: Emma Thomson
December 13, 2022
– DOL Issues Final Rule Amending Investment Duties Regulation –…
by: James Frazier
– Third time lucky or Schrems III? The European Union Data Pact with…by: Diletta De Cicco and James Downes
– Renewed Era of Crypto Assets Growth in Hong Kong by: Jay Lee
– Division I Universities Must Be Ready for Changes to the NCAA…by: Paul V.Kelly
– U.S.Supreme Court Hears Oral Argument in Case Testing Limits of…
by: Michelle E.Phillips and Christopher M.Repole
– Damages in Pre-Certification Discovery are Premature, Discovery…by: Jenniffer Cabrera
– When Chains Change, Do NFTs Stay The Same? How Hard Forks May Affect…by: Jason H.
Finger
– COVID-19: A Roadmap to Fraud Investigations: Office of Inspector…by: Stephen D.Bittinger
– DOJ Settlement with Electronic Health Records Provider Highlights…by: Ty E.
Howard and Lane M.Webster
– Update: OFCCP Plans to Disclose EEO-1 Data for Non-Objecting…by: Abby M.Warren
– Increasing US Enforcement Action for Sanctions Violations by Crypto…
by: Hannah Laming and Adam Klauder
– DOJ Antitrust Division and HHS OIG Enter into Partnership to Increase…by: Diane Hazel
– Can Discovery Be Compelled from a Party? Possession, Custody, Control…by: Kathryn C.Cole
– Weekly Bankruptcy Alert December 13, 2022 by: Bankruptcy & Creditors’ Rights
– California’s Newly Adopted “Safe Harbor” Warning Label for Acrylamide…
by: Taryn McPherson and Whitney Jones Roy
– Considerations for Public Company Bylaw Amendments in View of the New…by: Frank M.Placenti and Doron Lipshitz
– All Things Chemical® Podcast: TSCA Regulation of Articles: The Saga…
by: Lynn L.
Bergeson
– Telecom Alert: Providers Support 10-10.5 GHz NPRM; FCC Blocks Student…by: Jaimy “Sindy” Alarcon and Jim Baller
– New DOL Rule Enables Consideration of ESG Factors in Investing, Plus…by: Johnjerica Hodge and Danette R.Edwards
– Energy & Sustainability M&A Activity — December 2022 by: Thomas R.
Burton, III and Sahir Surmeli
– Court Holds NC State Health Plan Constitutes “Health Program or…by: Caroline Turner English and Alison Lima Andersen
– Energy & Sustainability IP Updates — December 2022 by: Brad M.Scheller
– Another Block Falls: BlockFi Files for Chapter 11 Protection,…by: David A.
Lopez-Kurtz and Alex J.Albers
– SEC Reopens Proposal on Stock Buyback Rules by: Erin Reeves McGinnis
– IRS Announces 2023 Increases to Estate and Gift Tax Exclusions by: Katlyn E.Koegel and Stephen C.Rohr
– FDA Letter States that β-Nicotinamide Mononucleotide is Not Lawful…by: Food and Drug Law at Keller and Heckman
– New York City’s Automated Employment Decision Tools Law Enforcement…
by: Adam S.Forman and Nathaniel M.Glasser
– Chips Chatter: December 5-12, 2022 by: Pablo E.
Carrillo and Ludmilla L.Kasulke
– FTC Releases Tentative Agenda for December 14 Open Commission Meeting by: Hunton Andrews Kurth’s Privacy and Cybersecurity
– How Many Behavioral Advertising Trackers Do Websites Deploy Currently? by: David A.Zetoony
– FRB Proposes Climate-Related Financial Risk Management Principles by: Daniel Meade
– Energy & Sustainability Litigation Updates — December 2022 by: Jacob H.Hupart
– Investor-State Arbitration: 2022 ICSID Rule Amendments and Update on…
by: Joseph J.Mamounas and Claudia D.Hartleben
– Warning Sign? A New Round of FDA Warning Letters Over CBD Consumer…by: J.
Hunter Robinson and Josh Kleppin
– Cross Border Recognition, 25 years on: the view from each side of the…by: Michelle N.Saney
– A New Era of Technology in the Private Markets by: Louis Lehot and Christopher Converse
– New York City Postpones Enforcement of Automated Employment Decision…by: Simone R.D.Francis
– New Law Seeks To Curtail Coerced Debts by: Keith Paul Bishop
– Republican SEC Commissioners Continue to Criticize Proposed Climate…
by: Jacob H.Hupart
December 12, 2022
– Raters gonna rate…but there’s a bright side! by: Daniel B.Guggenheim
– SEC Awards More than $20 Million to Whistleblower by: Mary Jane Wilmoth
– Duty to Preserve Evidence Covers Climate Review by Higher Educational…by: Monica H.
Khetarpal and Laura A.Ahrens
Guide to Creating a Corrective Action Plan Template
If your healthcare company has faced an audit by federal agencies or a private insurer, and that audit has uncovered severe or systemic billing errors, the payor will probably demand that you create and implement a Corrective Action Plan to prevent these errors in the future.Not adopting a Plan that satisfies the payor can lead to your healthcare company getting excluded from publicly-funded healthcare programs if the payor is the government, or losing its contract if the payor is a private insurance company.
Here is a guide to creating a general template that can be used to underpin a satisfactory Corrective Action Plan.
The “IERAIF” Template
Good Corrective Action Plans generally follow the “IERAIF” template.This mnemonic stands for:
Identify
Evaluate
Root cause analysis
Action plan
Implementation
Follow-up
Each step is very basic, but also essential for a functioning Plan.Payors that demand that you implement a Corrective Action Plan to continue billing them for healthcare services will expect that each step is present in your Plan, that the details in each are thorough and all-encompassing, and that the logistics for implementing each portion of the Plan are feasible.
While not all acceptable Corrective Action Plans are built off the IERAIF template, most use it as a starting point.
Identifying the Problem
The first step in any effective Corrective Action Plan is to identify the problem.
The good news is that the results of the audit or investigation into your company’s billing practices will usually identify and isolate the issues.In many cases, the audit results are thorough and detailed enough for you to use as the basis for your Corrective Action Plan.
However, that is not always the case.
Many investigations produce conflicting or confusing results or do not provide enough detail about the alleged billing problems to be useful in identifying the scope of the issue.Sometimes you will have to open a dialogue with the auditor to learn more about the billing problems or even have to conduct an internal audit to learn enough about the issues to start crafting a Corrective Action Plan to fix them.
Evaluate the Scope of the Problem
Once the specific billing issue has been identified, the next step in every effective Corrective Action Plan should be to evaluate the scope and severity of the problem.Is this an isolated anomaly, or is it a systemic problem that was repeated hundreds or potentially even thousands of times?
This evaluation is essential for understanding how pressing your response needs to be.All billing errors are significant, as they can trigger invasive and inconvenient audits that lead to findings of noncompliance and demands of overcharge reimbursements.However, if the issue was systemic, the costs of those overcharges will be exponentially higher and the likelihood that your healthcare company is cut off from a crucial source of funding will increase, as well.
Analyzing the Root Cause
Finding the billing problem should only be the first diagnostic step in a Corrective Action Plan.Billing errors are often caused by something deeper at your company, and looking through the error to find the root cause is essential for preventing it from happening in the future.
Some common root causes for billing discrepancies include:
Insufficient or confusing training sessions and materials
Outdated compliance protocols
Poor enforcement of those compliance protocols
Employee negligence
A lack of ongoing or follow-up training
If the root cause of a billing issue does not get addressed, the problems will continue.
Because this is the primary concern of your payor who is demanding a Corrective Action Plan, you can rest assured that this section of the Plan will occupy much of their attention.
The Action Plan
The other part of your Corrective Action Plan that is sure to be the focus of your payor’s attention is the action plan, itself.This part of the Plan details how your healthcare company aims to rectify the root cause of the billing problems.
It details the proposed corrective actions that will be taken and will serve as the protocol for future billing discrepancies of a similar nature.
Payors expect this part of your Plan to fully address the situation and to be severe enough to leave them assured that they will not have to revisit the billing issue in the future.
Some common action plans include:
Providing additional training to billing personnel
Terminating the medical coders who were responsible for the discrepancies
Updating training materials
Enforcing compliance mechanisms
Conducting an internal audit
Adopting verification procedures for invoices before they are sent
Providing incentives for error-free billing or imposing penalties for noncompliance
As Dr.Nick Oberheiden, founding partner of the national corporate compliance law firm Oberheiden P.C.and corrective action plan attorney, often tells his corporate clients, “The key to the action plan is to satisfy the payor while still maintaining full control over how your healthcare company functions.You want your payor to rest assured that the billing problems that were uncovered in their audit will not happen again.
However, you also want to avoid imposing such stringent compliance measures on your company that your bottom line suffers.”
Implementing the Fixes
Corrective Action Plans should also describe how the solutions will be implemented at your company.There are different ways to implement corrective actions.Many healthcare company executives who try to create their Plans struggle with this stage because it can be difficult to describe the corrective action process.However, your payor often expects details about the logistics so they know whether your Plan is feasible in action.
The Follow-Up
Without an effective follow-up, Corrective Action Plans might only give the appearance of fixing the billing issues.Payors are wary of this possibility and often demand a subsequent audit to ensure that the corrections outlined in the Plan were, in fact, successful and that the billing problems that necessitated the Plan are a thing of the past.
Conclusion
Creating an effective and your own Corrective Action Plan can ensure that you can continue to do business with a private insurer or government-funded healthcare program.The IERAIF template can be a useful starting place to ensure that you cover all of the necessary bases in your Plan in a step-by-step process..