Compliance

Many healthcare organizations are not aware of how critically important it is to screen their employees against ALL state and federal exclusions databases. The OIG is reviewing organizations in ALL federal healthcare programs - this includes Medicare, Medicaid, CHIP, etc. - for those who have employed individuals on ANY exclusions database. Not only must you screen employees on the OIG Exclusions database, but employers are also responsible to check state exclusions databases as well.

Employee Exclusions Screenings Must be High Priority

Many healthcare organizations are not aware of how critically important it is to screen their employees against ALL state and federal exclusions databases. The OIG is reviewing organizations in ALL federal healthcare programs - this includes Medicare, Medicaid, CHIP, etc. - for those who have employed individuals on ANY exclusions database. Not only must you screen employees on the OIG Exclusions database, but employers are also responsible to check state exclusions databases as well.

If your organization performs incident-to services, be sure to perform a periodic review of the rules that govern incident to and then compare them to the practices of your providers to ensure they would pass an audit.  Here are just a few of the guidelines that should be reviewed; however, for additional review,  the CMS guidelines for a quick review:

 

Qualifying Personnel:

How can I make sure new hires have not been in trouble with Medicare?

How can I make sure new hires have not been in trouble with Medicare?

Hardship Discounts

Insurance premiums and deductibles are going up and coverage seems to be going down. Even with ObamaCare, there will be plenty of folks out there without insurance or coverage for certain types of services. The shift, referred to by some as the “rise of the self-paying patient,” is creating nothing shy of a crisis for many healthcare providers.

HITECH Securing Data Guidelines

Properly securing data is an important HITECH component. Officially, organizations MUST be aware of the official "Guidance Specifying the Technologies and Methodologies that Render Protected Health Information Unusable, Unreadable, or Indecipherable to Unauthorized Individuals."

Protected health information (PHI) is rendered unusable, unreadable, or indecipherable to unauthorized individuals if one or more of the following applies:

  1. Valid encryption methods, or
  2. Proper destruction.

DATA IN MOTION

Protected Health Information De-Identification Standards

On November 26, 2012, the OCR released specific guidance regarding the de-identification of Protected Health Information (PHI). This guidance is the result of input from experts in various fields, workshops and in-depth research regarding various de-identification approaches. The intent of this guidance was to assist covered entities to understand:

Appointments, Reminders, Text Messaging, and HIPAA

March 2015

OSHA Penalty Information (Resource 271)

The following information by OSHA outlines the penalty structure for OSHA violations.  Emphasis has been added.

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