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Compliance
As TRICARE Breach Case Illustrates, Credit Services Can Be a Very Contentious IssueFrom Report on Patient Privacy - Credit monitoring, identify theft protection, financial restoration. What are these services and when are they beneficial — or a waste of money but likely to be offered anyway by a covered entity unfortunate enough to suffer a breach? There are no easy answers, as the health care world recently learned as it watched the Department of Defense (DoD) bungle its way through managing the biggest known health care breach, affecting 5.1 million people. The incident concerned the theft of back-up tapes from the car of a TRICARE business associate, Science Applications International Corp. Read more
With More Audits, Health Systems May Need a Centralized ResponseFrom Report on Medicare Compliance - If it had just been facing RAC audits, Advocate Health Care in Oak Brook, Ill., might have continued its largely decentralized approach to defending against government audits at its 12 hospitals. But as a slew of state and federal program-integrity contractors revved up their audit machines, it became clear to Advocate’s compliance department that a more coordinated, corporate response was necessary. Read more
Hospitals Settle Big-Dollar Stark, Kickback Civil Money Penalty Law Cases with OIGFrom Report on Medicare Compliance - Whidbey Island Public Hospital District in Coupeville, Wash., agreed to pay $858,571 to settle allegations that it violated the civil money penalty law related to Stark and kickbacks, the HHS Office of Inspector General said in late December. That’s a large fine for a single-hospital CMP settlement, although Whidbey is not alone. Read more
Compliance Blog
By Nina Youngstrom - February 17, 2012
By now, most people probably know that HHS has delayed the October 2013 implementation date of ICD-10 diagnosis and procedure codes. While HHS apparently responded to concerns raised by some sectors of the industry, the jury is still out on whether the delay will serve providers well. On the one...
By Francie Fernald - February 9, 2012
Physicians received two important notices recently, one from CMS issued Feb. 3, and the other from the HHS Office of Inspector General, issued Feb. 8.
The CMS notice is Trans. 2407, which takes effect on April 1. It establishes a new national policy for assignment of place of service (POS) codes....
By Nina Youngstrom - February 1, 2012
About five years ago, CMS started down the road toward penalizing hospitals for less-than-optimal patient outcomes with potential DRG cuts for hospital-acquired conditions (HACs). But as CMS implements new quality-related programs, such as value-based purchasing, readmission reductions and HACs for...
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