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November 24, 2014

Recent Stories of Interest

From Report on Medicare Compliance - Some hospitals have the illusion they are submitting admission orders to their Medicare administrative contractors when that’s not the case, a discrepancy that leads to claim denials, according to a Medicare administrative contractor (MAC) official. Hospitals must submit documentation, including admission orders, that supports their inpatient admissions as part of the probe-and-educate program, which requires MACs to evaluate compliance with the two-midnight rule. Read more

When the electronic health records of a physician at one hospital were… Read more

The formal requirement for physician certification of inpatient admissions will soon be… Read more

There’s a different flavor to the HHS Office of Inspector General’s Work… Read more

From the Editor

Welcome to your Report on Medicare Compliance subscriber-only Web page

Be sure to visit often, for PDFs of issues, archives of articles, links to government documents and more!

Please e-mail me with your comments on the last issue of Report on Medicare Compliance, story ideas for future issues, or any other suggestions you have that can make the newsletter more useful for you.

November 19, 2014
Justice Dept. Announces Revenue From Civil, Criminal Actions

The Justice Department collected $24.7B in civil and criminal actions in FY 2014, three times more than in FY 2013. http://tinyurl.com/mj9amrd

November 19, 2014
Two Court Decisions Impact Use of HIPAA in Lawsuits

The Connecticut Supreme Court overturned a lower court and will allow HIPAA to be used as the standard of care in a negligence lawsuit. Emily Byrne v. Avery Center for Obstetrics and Gynecology, P.C., SC 18904 (Nov. 11, 2014).

And the Indiana Court of Appeals issued its decision upholding the $1.44 million verdict against Walgreens because of a pharmacist’s unauthorized access to and disclosure of a customer’s prescription records. Walgreen Co. vs. Hinchy, No. 49A02-1311-CT-950 (Nov. 14, 2014).

November 18, 2014
OIG Report Details Management Challenges

OIG posts report on 2014 top management and performance challenges. http://go.usa.gov/sNTF

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