Medical Identity Theft

Posted on November 28, 2017

Has your facility implemented measures to prevent or reduce the risk of identity theft? An Identity Fraud Study conducted by Javelin Strategy & Research found that the identify fraud incidence rate has increased by sixteen percent.1 Medical/healthcare organizations were affected by 377 breaches which was 34.5 percent of the total breaches.2 These statistics reflect only those cases that were identified. According to the report, “These figures do not include the many attacks that go unreported. In addition, many attacks go undetected.” 3

Clinical connection

Posted on November 15, 2017

CMS and numerous speakers discuss patient centered care, the patient experience and the importance of both. Most, if not all care providers believe that patients should be at the center of all that we do, and that each patient deserves an out-standing experience while they entrust their precious lives to us.

November 2017: Quality Report

Posted on November 14, 2017

The recent report from Leapfrog and a review of the data caused consternation from this writer. It is important for everyone to know that I believe that data is critical and should be available for making knowledgeable decisions. However, after reviewing the Leapfrog report, it became quite apparent that measuring performance is clearly not a perfected science, and requires considerable man hours to assure accurate reporting.

October 2017: OIG work plan

Posted on October 25, 2017

Written by: Cheri Benander, MSN, RN, CHC, NHCE-C
These Work Plans serve as one of the resources that entities use to develop their internal audit plans. By using this resource, compliance officers can build a plan that is better aligned with the projects the OIG is pursuing in an effort to curb fraud and abuse.

September 2017: Are You Ready for a 501(R) Compliance Audit?

Posted on September 27, 2017

Written By: Cheri Benander, RN, MSN, CHC, NHCE-C
The Affordable Care Act (ACA) added additional requirements to the Internal Revenue Code section 501(r) for hospital organizations that want to be described as a Charitable 501(c)(3)hospital.

August 2017: Tracking Physician Activity

Posted on August 22, 2017

Written By: Cheri Benander, RN, MSN, CHC, NHCE-C
Severe penalties for noncompliant contracts and financial arrangements
with physicians can prove costly for small organizations. Violations of elements of the Stark, Anti-kickback, and Civil Monetary Penalty laws can also implement the False Claims Act making the financial effects even more devastating.

July 2017: Communication: A Key to Successful Compliance Programs

Posted on July 27, 2017

Developing a communication plan will help to ensure the success of your compliance program. Who, how, and when information is communicated are important aspects to consider when developing your strategies.

June 2017: Community Health Needs Assessment

Posted on June 13, 2017

Written By: Cheri Benander, RN, MSN, CHC, NHCE-C
On December 29, 2014, the Department of the Treasury and the Internal
Revenue Service released the final regulations implementing the Affordable Care Act (ACA) obligations for hospitals covered by §501(c)
(3) of the Internal Revenue Code. The ACA added §501(r) which specifies that hospital organizations will not be treated as tax-exempt under §501(c)(3) unless they meet certain requirements.

May 2017: HIPAA Non-Compliance Proves Costly

Posted on May 26, 2017

Written By: Cheri Benander, RN, MSN, CHC, NHCE-C
The Office of Civil Rights (OCR), enforcement agency for the Health Insurance Portability and Accountability Act (HIPAA), has announced several settlements over the past couple of months. The settlement amounts have been significant making it clear that a lack of compliance can be costly to an organization.

April 2017: Navigating the Maze

Posted on May 03, 2017

Written By: Cheri Benander, RN, MSN, CHC, NHCE-C
“The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians participating in Med- icare with potential payment cliffs for 13 years. “ The Act established new ways to pay physicians for the care that they provide Medicare beneficiaries. This new formula is based upon the quality and effectiveness of the care that is provided.

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