From Report on Medicare Compliance - When hospitals pay physicians handsomely for services provided to an unprofitable line of business, the government may suspect a Stark violation because the arrangement seems commercially unreasonable. But that misrepresents the way things work at nonprofit hospitals, which routinely use profits from healthier departments to keep money-losers afloat, a former prosecutor says. Read more

From Report on Medicare Compliance - As it considered a merger with another health system, WellSpan Health in York, Pa., handed part of due diligence to the compliance department. Since compliance is accustomed to evaluating its own billing and documentation, why not do the same for a potential partner and save a bundle by keeping the work in-house? WellSpan’s nurse auditors, coders, chargemaster analysts and compliance specialists dug in, says Wendy Trout, director of corporate compliance. Read more

Compliance Blog

By AIS Staff - July 15, 2014
The scandal at the Department of Veterans Affairs (VA) that has so outraged the nation over veterans’ access to medical care also has pointed the spotlight on whistleblowers and a covered entity’s compliance with whistleblower protection laws. This month’s issue of Report on Patient Privacy (RPP)...
By AIS Staff - June 16, 2014
Let’s say, for whatever reason, you wanted an electronic copy of your medical records. You have a right to them, by law, except that’s not what’s happening at many HIPAA covered entities. For its June issue, Report on Patient Privacy (RPP) took a look at the websites of several prominent health...
By Nina Youngstrom - March 10, 2014
Two recovery audit contractors have a bone to pick with some of the changes planned by CMS for the next round of the five-year RAC contracts and have filed “pre-award” protests with the Government Accountability Office (GAO), Emily Evans, a partner in Obsidian Research Group in Nashville, said at a...

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