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ASHRM Micro e-Learning: Disclosure – Pearls & Pitfalls
Strategies, tools, and practice for risk professionals needed to feel confident in managing the disclosure process.
Health Care Claims and Litigation Playbook
A valuable resource for any risk manager who has any responsibility for claims.
Webinars: Crisis Standards of Care: The Risk Management Perspective - Part 3
Building on Part 1 and 2, review the next steps in defending cases that arise during the pandemic.
Webinar: Reimagining the Continuum of Risk: Why Early Resolution Is the Answer
In this panel discussion, top health care risk management and technology leaders discuss how early resolution approaches, like CRPs, can positively reshape and redefine your organization's approach to risk.
Investigations Complete Module Set
This online course is an interactive and robust walk-through of the investigation process from the beginning to the end, often examining the implications for your own organization.
Activities that Lead to Civil and Criminal Litigation in Health Care
Learn what constitutes medical malpractice, how to identify when it may have occurred, and what proactive and reactive risk management strategies to take to prevent these types of errors from occurring in your workplace.
DOL sues UnitedHealth third-party administrator for improperly denying ED claims
The Department of Labor July 31 sued a third-party administrator owned by UnitedHealth Group in the U.S. District Court for the Western District of Wisconsin, alleging it improperly denied claims for emergency services and urinary drug screening since 2015.
Report: Anthem has yet to process nearly $300 million in N.H. hospital claims
The New Hampshire Hospital Association recently released a report highlighting the challenges New Hampshire hospitals and health systems face in dealing with Anthem, the state’s largest insurance provider, including nearly $300 million in unprocessed claims for services provided by New Hampshire hospitals.
Anthem Indiana’s ED “Downgrade” Policy Found to “Clearly” Violate Federal Law
An arbitrator has ordered that Anthem Insurance Company, Inc. (“Anthem”) pay a group of 11 acute care hospitals in Indiana (“hospitals”) $4.5 million as compensation for adopting a policy of processing claims for emergency services that the arbitrator found is a “clear” violation of federal and state law.
DOJ releases formal guidance for litigators in False Claims Act cases
The Department of Justice this week issued formal guidance on how it awards credit to defendants who cooperate during a False Claims Act investigation.