Preventive Medicine: An Attorney's Reimbursement Compliance Program

The Department of Health and Human Services' Office of Inspector General has developed and published voluntary compliance program guidance focused on several areas and aspects of the health care industry. Over the years, the OIG has developed specific compliance program guidance related to claims submissions for hospitals, hospices, individual and small group physician practices, nursing facilities, ambulance suppliers, third-party medical billing companies, and the list goes on. The OIG believes that the development and issuance of voluntary compliance program guidance will serve as a positive step toward assisting health care providers and others in the health care industry in preventing the submission of erroneous claims or engaging in unlawful conduct involving the federal health care programs, and knowledgeable health care attorneys agree.

Preventive Medicine: An Attorney's Reimbursement Compliance Program

The Department of Health and Human Services' Office of Inspector General has developed and published voluntary compliance program guidance focused on several areas and aspects of the health care industry. Over the years, the OIG has developed specific compliance program guidance related to claims submissions for hospitals, hospices, individual and small group physician practices, nursing facilities, ambulance suppliers, third-party medical billing companies, and the list goes on. The OIG believes that the development and issuance of voluntary compliance program guidance will serve as a positive step toward assisting health care providers and others in the health care industry in preventing the submission of erroneous claims or engaging in unlawful conduct involving the federal health care programs, and knowledgeable health care attorneys agree.

Preventive Medicine: An Attorney's Reimbursement Compliance Program

The Department of Health and Human Services' Office of Inspector General has developed and published voluntary compliance program guidance focused on several areas and aspects of the health care industry. Over the years, the OIG has developed specific compliance program guidance related to claims submissions for hospitals, hospices, individual and small group physician practices, nursing facilities, ambulance suppliers, third-party medical billing companies, and the list goes on. The OIG believes that the development and issuance of voluntary compliance program guidance will serve as a positive step toward assisting health care providers and others in the health care industry in preventing the submission of erroneous claims or engaging in unlawful conduct involving the federal health care programs, and knowledgeable health care attorneys agree.

On the Road: Growing Pains for PreCheck Airport Security Program

All he wanted was some information about PreCheck, the program of the Transportation Security Administration that gives eligible fliers a quick-pass through airport security. His boarding pass had the PreCheck certification, but the PreCheck lane was available only in a terminal separate from the one where his flight was to depart at Newark Liberty International Airport.

After 15 minutes with one of those dreaded automated phone systems, Mr. Ax finally got through to an airline agent and inquired politely about the machinations of getting through PreCheck in one terminal while flying out of another. Couldn’t be done easily, it turned out.

“The guy starts yelling at me, ‘That’s not my problem, that’s the T.S.A.’s problem!’ ” he said. “He was literally shouting.”

Mr. Ax says he does about 85 concerts a year, about 50 of them requiring air travel. He belongs to Global Entry, the popular “trusted traveler” program of the Customs and Border Protection agency that gives a quick-pass re-entry into the country for international travelers. Global Entry members also are automatically enrolled in PreCheck.

“So that’s fantastic. But I’ve had PreCheck for six months, and unfortunately I’ve been able to use it exactly once, at O’Hare, despite all the flying I do,” he said.

Mr. Ax’s frustration with PreCheck partly reflects high expectations that bump into the realities of how limited the program really has been so far. It’s operating in 40 airports, but the availability is limited to participating airlines, and only at certain terminals.

Last week, the T.S.A. announced an aggressive expansion of PreCheck that the agency says will add 60 new airports by the end of this year. Participating airlines now are Alaska, American, Delta, Hawaiian, United, US Airways and Virgin America. JetBlue and Southwest are expected to join the program soon, the agency said.

When it began in October 2011, PreCheck was available only to high-status, high-revenue passengers chosen by individual airlines to participate — an approach that irritated many frequent travelers who failed to make the invitation lists. Then PreCheck also became open to those who belong to Global Entry and other so-called known-traveler programs. That prompted many travelers to join Global Entry, even if they didn’t fly internationally. Global Entry costs $100 for five years and requires a background check, fingerprinting and a personal interview.

In July, John S. Pistole, the T.S.A. administrator, announced a major expansion to increase the numbers of travelers in PreCheck, starting this fall in an initiative that he has referred to as “Global Entry Lite.” Travelers will be able to apply directly for PreCheck, paying an $85 fee good for five years, and reporting to airport enrollment centers for fingerprinting. That expansion is expected to start at two airports, Washington Dulles and Indianapolis, and roll out more widely through the fall.

The ambitious goal of the T.S.A. is to have 25 percent of all airline travelers in the United States eligible for expedited screening by the end of this year through PreCheck. On Monday, the T.S.A. said it would also offer PreCheck on a case-by-case basis to randomly selected passengers based only on the information they provide at booking.

Still, there’s a good amount of confusion about PreCheck. For one thing, even some frequent business travelers that I hear from who belong to Global Entry don’t realize that to also qualify for PreCheck, they have to enter their Global Entry identification numbers in their frequent-flier profiles of participating airlines. (Those entering PreCheck in the new application process will receive what the T.S.A. calls a Known Traveler Number.)

Once enrolled, a traveler should see the PreCheck certification on the bar code of each boarding pass from a participating airline. But that doesn’t always ensure an expedited passage through security, in not having to take off shoes or remove laptops from their cases. A certain amount of randomness is built into the system, so a passenger with PreCheck still may occasionally be directed instead to the regular screening lanes.

The T.S.A. has detailed information on PreCheck, including links for participating airlines and locations of PreCheck lanes in the 40 airports where the program is now operating.

Incidentally, I hear nothing but good things from readers about Global Entry, which allows returning travelers to be whisked through international airport border-entry points using special kiosks that eliminate those hated long waits in line. PreCheck is a work in progress.

“Global Entry works very well. It’s just excellent. PreCheck, however? They keep advertising it, but the truth is, it’s just not available in many places yet,” Mr. Ax said.

Preventive Medicine: An Attorney's Reimbursement Compliance Program

The Department of Health and Human Services' Office of Inspector General has developed and published voluntary compliance program guidance focused on several areas and aspects of the health care industry. Over the years, the OIG has developed specific compliance program guidance related to claims submissions for hospitals, hospices, individual and small group physician practices, nursing facilities, ambulance suppliers, third-party medical billing companies, and the list goes on. The OIG believes that the development and issuance of voluntary compliance program guidance will serve as a positive step toward assisting health care providers and others in the health care industry in preventing the submission of erroneous claims or engaging in unlawful conduct involving the federal health care programs, and knowledgeable health care attorneys agree.

Disappointing Fall for ‘Rock Center,’ a News Program With Big Ambitions

The ambitious NBC newsmagazine was scheduled to be shown for the final time on Friday night. Within NBC News, employees expressed a sense of disappointment — not so much in the quality of the program, but that it was not rated highly enough to remain on the network schedule. To those who invested much in producing the show, its demise raises doubts about whether any new newsmagazine can succeed on network television these days.

To that point, Rome Hartman, the founding producer of “Rock Center,” said in an interview: “I hope that’s not true. I sure hope that somebody figures it out.”

“Rock Center” was the first new prime-time newsmagazine to be introduced by any network since CBS added “60 Minutes II” in 1998. Mr. Williams, the anchor of “NBC Nightly News,” had been eager to try something in prime time, and when Comcast took control of NBCUniversal in 2011, he got his chance. For Comcast, giving the go-ahead to “Rock Center” was, among other things, a way to provide clear support to the network news division it had just acquired.

The newsmagazine had its premiere on Halloween. Unlike CBS’s “48 Hours” and NBC’s “Dateline,” which are mainly about crimes and court cases, “Rock Center” presented a wide array of stories each week and was closer to the “60 Minutes” model than anything else on television. But the comparisons to “60 Minutes” were rarely complimentary; “It’s a very hard standard to match,” Mr. Hartman said.

More important, “60 Minutes” was able to find its footing four decades ago, before the days of cable and Internet competition. It has a protected Sunday night time slot that often gets a big ratings lift from sporting events that are shown beforehand.

“60 Minutes II,” on the other hand, was canceled in 2005. And “Rock Center” was canceled in May, shortly before NBC announced its schedule for the television season that starts in September. With an audience that sometimes slipped below three million people, the network could not justify another season of “Rock Center.”

At a time when audiences have far more choices than ever before, online as well as on TV, the people involved with “Rock Center” may have simply overestimated the public’s appetite for taped news stories in prime time. Said one former NBC executive: “You can’t launch a serious newsmagazine anymore. Those potential viewers, if they’re around, they’re watching cable news.”

There is no shortage of niche news and information programming on cable. CNN, for instance, will show a new documentary series from Morgan Spurlock this Sunday. HBO recently granted a second season to a youthful newsmagazine, “Vice,” and OWN has “Our America,” hosted by Lisa Ling. These programs, though, do not have the sweep of a network newsmagazine.

If the decision to cancel “Rock Center” was not surprising, it was still dismaying to Mr. Williams and to others on the staff, some of whom will lose their jobs after Friday’s final broadcast. (Many others will be absorbed by other NBC News programs.) One staff member said Mr. Williams felt insulted by the network’s decision; another said what pained Mr. Williams most were the layoffs. Staff members were told not to talk to the news media, so those who did speak did so on condition of anonymity.

An NBC spokeswoman said on Thursday that Mr. Williams was not available for an interview about the program’s accomplishments. Patricia Fili-Krushel, the chairwoman of the NBCUniversal News Group, declined through a spokeswoman to comment on the end of “Rock Center.”

Staff members expressed pride in the program, asserting that it was a rare outlet for interviews and investigations that lasted longer than a few minutes. (Typically the program had three to five stories an hour. Once in a while the hour was devoted to a single subject, like one show titled “Mormon in America.”)

Tech Companies Concede to Surveillance Program

Twitter declined to make it easier for the government. But other companies were more compliant, according to people briefed on the negotiations. They opened discussions with national security officials about developing technical methods to more efficiently and securely share the personal data of foreign users in response to lawful government requests. And in some cases, they changed their computer systems to do so.

The negotiations shed a light on how Internet companies, increasingly at the center of people’s personal lives, interact with the spy agencies that look to their vast trove of information — e-mails, videos, online chats, photos and search queries — for intelligence. They illustrate how intricately the government and tech companies work together, and the depth of their behind-the-scenes transactions.

The companies that negotiated with the government include Google, which owns YouTube; Microsoft, which owns Hotmail and Skype; Yahoo; Facebook; AOL; Apple; and Paltalk, according to one of the people briefed on the discussions. The companies were legally required to share the data under the Foreign Intelligence Surveillance Act. People briefed on the discussions spoke on the condition of anonymity because they are prohibited by law from discussing the content of FISA requests or even acknowledging their existence.

In at least two cases, at Google and Facebook, one of the plans discussed was to build separate, secure portals, like a digital version of the secure physical rooms that have long existed for classified information, in some instances on company servers. Through these online rooms, the government would request data, companies would deposit it and the government would retrieve it, people briefed on the discussions said.

The negotiations have continued in recent months, as Martin E. Dempsey, chairman of the Joint Chiefs of Staff, traveled to Silicon Valley to meet with executives including those at Facebook, Microsoft, Google and Intel. Though the official purpose of those meetings was to discuss the future of the Internet, the conversations also touched on how the companies would collaborate with the government in its intelligence-gathering efforts, said a person who attended.

While handing over data in response to a legitimate FISA request is a legal requirement, making it easier for the government to get the information is not, which is why Twitter could decline to do so.

Details on the discussions help explain the disparity between initial descriptions of the government program and the companies’ responses.

Each of the nine companies said it had no knowledge of a government program providing officials with access to its servers, and drew a bright line between giving the government wholesale access to its servers to collect user data and giving them specific data in response to individual court orders. Each said it did not provide the government with full, indiscriminate access to its servers.

The companies said they do, however, comply with individual court orders, including under FISA. The negotiations, and the technical systems for sharing data with the government, fit in that category because they involve access to data under individual FISA requests. And in some cases, the data is transmitted to the government electronically, using a company’s servers.

“The U.S. government does not have direct access or a ‘back door’ to the information stored in our data centers,” Google’s chief executive, Larry Page, and its chief legal officer, David Drummond, said in a statement on Friday. “We provide user data to governments only in accordance with the law.”

Statements from Microsoft, Yahoo, Facebook, Apple, AOL and Paltalk made the same distinction.

But instead of adding a back door to their servers, the companies were essentially asked to erect a locked mailbox and give the government the key, people briefed on the negotiations said. Facebook, for instance, built such a system for requesting and sharing the information, they said.

The data shared in these ways, the people said, is shared after company lawyers have reviewed the FISA request according to company practice. It is not sent automatically or in bulk, and the government does not have full access to company servers. Instead, they said, it is a more secure and efficient way to hand over the data.

Tech companies might have also denied knowledge of the full scope of cooperation with national security officials because employees whose job it is to comply with FISA requests are not allowed to discuss the details even with others at the company, and in some cases have national security clearance, according to both a former senior government official and a lawyer representing a technology company.

Reporting was contributed by Nick Bilton, Vindu Goel, Nicole Perlroth and Somini Sengupta in San Francisco; Edward Wyatt in Washington; Brian X. Chen and Leslie Kaufman in New York; and Nick Wingfield in Seattle.

A Program to Combat Food Contamination

The initiative, unfolding along neatly planted rows of berries at the Andrew & Williamson Fresh Produce’s Sierra Farm here, is an effort to prevent the types of bacterial outbreaks of salmonella, listeria or E.coli that have sickened consumers who ate contaminated cantaloupes, spinach or other produce.

One of the workers, Valentin Esteban, is on the front lines of the new effort, having gone through a training program that helps him avoid practices that lead to possible bacterial contamination that could undermine the safety and quality of the strawberries he picks.

In exchange, Andrew & Williamson is providing Mr. Esteban better pay and working conditions than many migrant farmworkers receive, a base pay of $9.05 an hour versus the $8 average in the area.

“Sure, the money is important, but I also feel good because I am helping to improve quality and safety,” Mr. Esteban said. “Those things are important to my family, too.”

Last summer, more than 250 people in 24 states were sickened and three died after eating cantaloupes contaminated with salmonella. A year earlier, cantaloupe tainted with listeria killed 33 people.

The Food and Drug Administration laid the blame on conditions like stagnant pools of water and dirty surfaces in packing areas, problems that farm workers could help prevent.

“In those cases, the workers weren’t trained to address it or even recognize that those conditions might be problematic,” said Peter O’Driscoll, project director of Oxfam America’s Equitable Food Initiative. “Farm workers can be the eyes and ears of the farm, helping to improve food safety and pest contamination.”

Under the new program, with Andrew & Williamson the first grower to participate, berries sold under the label “Limited Edition,” would carry certification to inform consumers that food safety protocols had been followed and that the workers who harvested the crop were treated fairly.

With Andrew & Williamson paying higher wages than almost all its competitors, the participants in the program hope that the promise of better-quality, safer fruit and better conditions for workers will entice distributors, retailers and consumers to pay a little more, too.

Costco has agreed to play a major part and pay a little extra for the berries once they are certified.

“Who is it that’s delivering the result — safer, higher-quality berries? Those workers,” said Jeff Lyons, the company’s senior vice president for fresh foods. “So yes, I’m willing to pay more, so long as the certification really means something.”

Costco’s participation was critical, said Dan Glickman, an Oxfam America board member who was agriculture secretary during the Clinton administration. “This can’t be a field of dreams, where if we grow it this way, they will buy it no matter the cost,” Mr. Glickman said. “Having a retailer like Costco buy into it was key.”

Ernie Farley, a partner of Andrew & Williamson, pointed to the important role that farm workers play. “This program means that instead of one auditor coming around once in a while to check on things, we have 400 auditors on the job all the time.”

The company, which grows berries, tomatoes and cucumbers, pays a higher base wage than most growers, according to the United Farm Workers union. Andrew & Williamson also provides clean bathrooms, gloves to protect pickers’ hands, folding chairs to sit on at lunchtime and other seemingly small but much appreciated perks, like cups for water from coolers, a rare luxury for the workers.

In the program, the workers are trained in practices that enhance food safety — from not wearing jewelry that might fall into boxes of berries to spotting signs of contaminants and insects or other pests that might spoil crops. These practices can reduce the use of pesticides, something that the environmental groups participating in the project are pushing for.

Reporter's Notebook: Pro Bono Program May Help Traffic Court Image

As part of reporting a story on the future of the Philadelphia Traffic Court after allegations of ticket-fixing have become widely publicized, I learned about an upcoming program that is aiming to help ex-convicts set up payment plans for past traffic infractions in order to get their driver's licenses restored.

TED Teams Up With PBS for Education Program

Television viewers — even those who watch the more sober-minded PBS — are generally not keen on sitting through long speeches. But TED, the nonprofit group that sponsors conferences on ideas, thinks it has found a way to bring its signature 18-minute talks to a TV audience that may not have found them on the Web or through mobile apps.

In its first television foray, TED has joined forces with the Corporation for Public Broadcasting and the New York public broadcaster WNET for a one-hour special, “TED Talks Education,” to be broadcast on PBS on Tuesday. If it is successful, the program could become a template for future joint projects, said Juliet Blake, one of the show’s executive producers and the TED official charged with bringing the conferences to television.

The program was 18 months in the making, a short time for public broadcasting but long for TED, which is accustomed to the more immediate online world. Other suitors have also sought to do TED television projects, Ms. Blake said, but “to reach the audience we want to reach, public television was the place.”

The Corporation for Public Broadcasting paid for the show’s $1 million costs under the auspices of an initiative that addresses the high school drop-out problem in the United States. “It was the perfect marriage of ideas that matter and our core value of education,” said Patricia Harrison, the corporation’s chief executive.

Hosted by the singer John Legend, who also has a foundation focused on alleviating poverty by improving education, and taped in April before an audience at the Brooklyn Academy of Music, the show features teachers, students and educational reform advocates like Bill Gates.

The final speaker is the English author Sir Ken Robinson, whose 2006 TED talk arguing for more creativity in schools has been seen nearly 16 million times, making it by far the TED Web site’s most popular video.

The focus is on positive changes that speakers advocate. Mixed in are clips of students discussing what excites them in school.

In one concession to the medium, the show limited its speakers to 5 to 8 minutes. “People don’t sit in front of television and watch 18-minute speeches,” said Julie Anderson of WNET, also an executive producer. Some speakers went long, including Geoffrey Canada, the chief executive of Harlem Children’s Zone, so those talks were edited for the PBS program, although the full-length versions will be posted online.

Federal Judge Rules on Heart Of Medicare Part D Program

A qui tam suit alleging fraud against one of the biggest private contractors for the multibillion-dollar Medicare Part D prescription-drug program survived a motion to dismiss last week.

Reporter's Notebook: Pro Bono Program May Help Traffic Court Image

As part of reporting a story on the future of the Philadelphia Traffic Court after allegations of ticket-fixing have become widely publicized, I learned about an upcoming program that is aiming to help ex-convicts set up payment plans for past traffic infractions in order to get their driver's licenses restored.

First-of-Its-Kind Program Concentrates on Animal Law

Mitzi Bolanos adopted a pit bull a few years ago, only to find that discrimination was part of the deal. Because of her dog, she was often told where she could or couldn't live or work.

"I am a Hispanic female, and I never felt discriminated against in this country until I started walking around with my pit bull," Bolanos said.

In September, the 28-year-old lawyer went back to school to get a master's of laws in animal law. She wants to use her degree -- the first of its kind in the world -- to help fight breed bias.

Bolanos will be among the first class of six students to get such a degree from Lewis & Clark Law School's Center for Animal Law Studies. Enrollment in the yearlong program is expected to grow to 15 or 20 students in three to five years, said attorney Pamela D. Frasch, assistant dean and executive director of the law center.

Interest and enrollment at Lewis & Clark for the $35,000-a-year program have mirrored the pet revolution in the United States, Frasch said.

"But while laws have improved and grown, there is still a disconnect between what animals deserve and what protections they get," Frasch said. That led Lewis & Clark to develop the master's of laws program with the Animal Legal Defense Fund in Portland, Ore.

Bolanos grew up in Miami, where pit bulls are banned. When she moved to New Orleans in 2011, she volunteered at the Louisiana Society for the Prevention of Cruelty to Animals. She adopted a pit bull named Bubba who was covered in scars and had a fresh chemical burn down his back.

Life with a pit bull hasn't been easy. She said she has faced citywide breed bans and at homes in cities without bans. She said their travel was restricted when she wanted to take the 65-pound Bubba home for the holidays, but most airlines banned Bubba's breed and one required an expensive "dangerous dog" crate.

More than 650 U.S. cities ban pit bulls or require sterilization, muzzles in public or extra insurance. Some regulate the size of fences that keep pit bulls enclosed or the weight of leashes that keep them restrained. Even the Army and the Marines ban pit bulls in base housing.

According to DogsBite.org, a Texas-based dog bite victims' group that encourages breed bans, pit bulls were responsible for 22 of 31 fatal dog attacks in 2011. The breed -- loosely defined as American pit bull terriers, American Staffordshire terriers or Staffordshire bull terriers -- is large, strong and easily trained to fight, making them targets for dogfighting operations. You must be signed in to comment on an article

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