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Medicare Advantage (MA) plans may be doing just what the name says- taking advantage of Medicare. It is highly unlikely that this was the intention in 2003 when MA plans were created by nongovernment entities using a capitated managed care reimbursement approach. The amount of Medicare reimbursement to the MA plan is fixed and calculated […]
Healthcare organizations have many relationships to manage, including patients, providers, payers, and vendors. On top of this, some relationships require a Business Associate Agreement (BAA) to comply with HIPAA. In order to determine if such an agreement is necessary, it is crucial to look at each relationship individually in order to provide proper treatment and […]
What can we learn from the Office for Civil Rights’ (OCR) recent announcements regarding two of the largest settlements ever reported for HIPAA violations? The settlements total $3.9 million and $1.5 million respectively and both stem from an unencrypted laptop stolen from an employee’s car. The Feinstein Institute of Medical Research suffered a data breach in 2012 of over 13,000 […]
Protecting the integrity of the Medicare program is a top priority. Fortunately, the Affordable Care Act has allotted significant funding for task forces to root out fraud, waste and abuse. Up until now, the task forces have focused recovery efforts on funds already paid to the providers and suppliers. The new focus is on prevention […]
Just as important as the timely renewal of licenses, awareness of all deadlines required by covered entities and business associates is necessary to avoid potential violations and subsequent penalties. The HIPAA Final Omnibus Rule shortened the time requirement to meet a few of these deadlines that require a specific action be taken by the covered […]
Due to the challenges of implementing Meaningful Use, it is unsurprising the Center for Medicare and Medicaid Service (CMS) is finally rethinking the plan. The goal of Meaningful Use (MU) to achieve nationwide electronic health record (EHR) interoperability and ultimately improve overall healthcare remains intact. Until further details and a formal announcement, certain steps will […]
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 […]
As the world of healthcare evolves, more and more healthcare providers are turning to mobile devices in their practice. If you are a covered entity, you are responsible for complying with HIPAA regulations for securing private patient information, including when using mobile devices. Here are some guidelines to ensure security while using mobile devices: Before […]
An increasingly important issue for many providers is the dilemma of providing care that is satisfactory to the patient while avoiding overutilization and its effect on reimbursement. Unfortunately, the patient’s perceived satisfaction may not be a result of receiving the best quality of care and in some cases may be due to inappropriate or wasteful […]
