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Jumpstart Your Compliance Program

The beginning of the New Year is a popular time for new initiatives. Many healthcare organizations are looking for ways to improve quality and reduce risk. A compliance program is an effective way to detect, deter and prevent wrongdoing in the healthcare setting and an ongoing system assures conformity with governing laws and regulations. An

Is Your Compliance Program Effective?

Having a compliance program in place is a start but having an effective compliance program is the goal. Proactively assessing the effectiveness of one’s own compliance program is better than the Department of Justice making a determination of the adequacy as a result of an investigation for alleged misconduct. To set benchmarks for an effective

Deadline for Breach Reporting Coming Soon

As the end of the year approaches, keep in mind that all breaches of unsecured protected health information involving less than 500 individuals must be reported to the Secretary at the Department of Health and Human Services (HHS) within 60 days of the end of the calendar year. If the organization already reported a breach

Overview of a Corporate Integrity Agreement (CIA)

Health care fraud recoveries for fiscal years 2009- 2014 exceeded previous records with five straight years of more than $2 billion in annual recovery from cases involving fraud and false claims against federal health care programs such as Medicare and Medicaid.  Most healthcare providers are aware of significant civil liability due to recent enforcement. However,

Don’t Pay for Free Workplace Posters That Are Required By Law

Employers are required to advise employees of their federal rights in the form of displaying federally required posters in the workplace. Compliance with these federal requirements is necessary to avoid strict fines and penalties. Unfortunately, many employers pay unscrupulous companies for these posters when they are offered for free on the respective government websites. In

Are You Aware of the Whistleblower Provisions of the False Claim Act ?

The whistleblower provisions of the False Claims Act have lead to several newsworthy cases in recent years. Just a few days ago, the Justice Department announced that KMART Corporation (Kmart) will pay $1.4 Million to resolve False Claims Act allegations for knowingly providing coupons to Medicare beneficiaries to waive or reduce co-pays for purchasing more

How do you fire a patient?

Obviously, no one wants to terminate a patient, but sometimes it is reasonable and in the best interest of both parties.  There are circumstances when it may be within the rights of the provider and appropriate to terminate a patient. Some examples include a patient who: -No-shows or cancels appointments frequently or repeatedly -Does not

Does The Sunshine Act Apply To You?

Are you a licensed physician in the US? If the answer is yes and you are not a medical resident then The Physician Payments Sunshine Act applies to you. Beginning August 1, 2013, The Physician Payments Sunshine Act OPEN PAYMENTS program requires transparency of any financial interactions between physicians or hospitals with any applicable manufacturers

What is the timeline for your practice?

Running a practice requires adherence to a complicated timeline.  Below is a summary of important dates to add to your calendar. 2013 eRx PAYMENT ADJUSTMENT of -1.5% for Eligible Professionals and group practices in GPRO who: a) Were not successful electronic prescribers in 2011 or b) Failed to report claims for 10 billable Medicare B

What is the timeline for your practice?

Running a practice requires adherence to a complicated timeline.  Below is a summary of important dates to add to your calendar. 2013 eRx PAYMENT ADJUSTMENT of -1.5% for Eligible Professionals and group practices in GPRO who: a) Were not successful electronic prescribers in 2011 or b) Failed to report claims for 10 billable Medicare B