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December 5, 2016

Recent Stories

From Report on Medicare Compliance - Hospitals that turned down CMS’s 2014 appeals settlement have another shot on Dec. 1, but this time they will get less money — although it probably will come faster. CMS officials were a little opaque about the reason hospitals will receive 66% instead of 68% of the net allowable amount of denied patient-status claims in return for withdrawing appeals, but they indicated on a Nov. 16 call that it’s the price hospitals pay for the “additional burden” of CMS taking on a second settlement process. Read more

The pioneering treatment at your hospital, where surgeons are injecting adenoviruses and… Read more

Post-acute providers, which sometimes draw the short compliance straw, are all over… Read more

A slew of program-integrity measures, including the Medicare-Medicaid 60-day overpayment refund rule,… 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.

December 2, 2016
More Info on Phishing Scam; New Audits Announced

The Office for Civil Rights issued two important announcements via email on Nov. 30.

First, it added more information regarding the phishing scam that appears to come on official HHS letterhead (see Nov. 28 post below). The phishing email originates from the email address and directs individuals to a URL at Notice the slight difference between the fake email address (italicized above) and OCR’s email. OCR’s email is

Second, OCR said that it had notified select business associates of their inclusion in the Phase 2 HIPAA audits.

November 30, 2016
OIG Posts Semiannual Report to Congress for Six Months Ending Sept. 30

OIG posted its Semiannual Report to Congress for the six months ending Sept. 30, 2016.

November 28, 2016
OCR Issues Alert About Phishing Scam on Fake HHS Letterhead

Critical Alert from OCR: On Nov. 28, OCR sent out the following alert on its OCR listserv regarding phishing scams :

"It has come to our attention that a phishing email is being circulated on mock HHS Departmental letterhead under the signature of OCR’s Director, Jocelyn Samuels. This email appears to be an official government communication, and targets employees of HIPAA covered entities and their business associates.

The email prompts recipients to click a link regarding possible inclusion in the HIPAA Privacy, Security, and Breach Rules Audit Program. The link directs individuals to a non-governmental website marketing a firm’s cybersecurity services.

In no way is this firm associated with the U.S. Department of Health and Human Services or the Office for Civil Rights. We take the unauthorized use of this material by this firm very seriously. In the event that you or your organization has a question as to whether it has received an official communication from our agency regarding a HIPAA audit, please contact us via email at"

Do not open this email or click on the link.

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