Health Law Blog - Healthcare Legal Issues

Managed Care and ACO Compliance Issues

Through our Clinical Integration and Managed Care practice, we have developed a proactive approach to compliance with the unique and significant regulatory issues that have been created by health care reform laws.  We have been substantially involved in creating compliance programs and structures that meet the needs of payors and provider groups.  Some of our activity in this area includes:

  • Health System Compliance Program Effectiveness Review
  • Compliance Program Creation – Large Multi Facility Organization
  • Creation of ACO Compliance Program
  • Development of CIN Compliance Program
  • FDR Compliance Program Requirements
  • Medicare Advantage Compliance Issues
  • Provider Self Disclosure Process – Excluded Party
  • Provider Self Disclosure Process – Physician Compensation
  • OCI Complaints Regarding Alleged Privacy Breach
  • Developed Audit Standards for Compliance Program
  • Structure Annual Audit Plan
  • Assist with Creating Compliance Heat List
  • Guidance on Routine Compliance Complaints
  • Exchange Act (HIX) Compliance Program Structures
  • HIPAA Compliance Program
  • Business Associate Relationships and Compliance Issues
  • Addressed Various HIPAA Issues
  • Handled OCI Complaints and Investigations
  • HIPAA Privacy and Security Policy Creation
  • Employer Sponsored Health Plans
  • ERISA Compliance Issues
  • Multi Employer Health and Welfare Plan Issues
  • Employer Based Clinics
  • Data Use Policies and Standards
  • Data Related Agreements
  • Created Data Policies for Large Organization
  • Meaningful Use Compliance Issues
  • E.H.R. Donation Agreements and Issues
  • Software and Infrastructure Acquisition
  • Ongoing Support Agreements
  • Data Protection Programs


John H. Fisher

Health Care Counsel
Ruder Ware, L.L.S.C.
500 First Street, Suite 8000
P.O. Box 8050
Wausau, WI 54402-8050

Tel 715.845.4336
Fax 715.845.2718

Ruder Ware is a member of Meritas Law Firms Worldwide

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