News
The U.S. Department of Health and Human Services Office of the Inspector General has released its report for the six-month period ending March 31, 2011. The report contains details on OIG’s enforcement activities regarding Medicare and Medicaid fraud and abuse, its recommendations for ways to save taxpayer money and improve HHS programs, investigation of pharmaceutical companies, efforts to reduce adverse hospital events, and its education and outreach activities.
The entire report can be viewed here (a brief “highlights” section can be found at the beginning of the document).
June 14th, 2011
On June 8, 2011, the Department of Justice announced that a West Palm Beach, Florida radiology clinic and its former owners will pay $3 million to settle allegations that the clinic violated the False Claims Act. The clinic, Midtown Imaging, is alleged to have entered into leasing and professional services agreements with providers which violated the Anti-Kickback Statute and Stark Law. These laws are intended to keep physicians’ medical decisions from being influenced by improper financial incentives.
The full press release is available here.
June 10th, 2011
The U.S. Dept. of Health and Human Services (HHS) has proposed a change under HIPAA’s Privacy Rule which would give patients the right to a report on who has accessed their electronic protected health information. The proposed rule is made pursuant to HITECH, part of the American Recovery and Reinvestment Act of 2009. The rule is open to comment until August 1, 2011
HIPAA currently requires tracking of who has accessed and viewed a patient’s protected health information; the proposed rule would give patients the ability to request the information in a report.
People may now read the proposed rule here.
June 7th, 2011
The OIG has collected the reports of each state’s Medicaid Fraud Control Unit (MFCU) for Fiscal Year 2010 and compiled the data into one Excel chart, available here.
On a national level, 13, 210 investigations were conducted, stemming from both fraud and abuse/neglect, which led to 1,603 indictments and 1,329 convictions. The states reported a total of $1.8 billion in civil and criminal recoveries, which OIG calculates as a return on investment (ROI) of $8.98 per every dollar of MFCU funding by the federal and state government .
Based on the spreadsheet, North Carolina’s MFCU conducted 230 investigations (208 for fraud, 22 for abuse and neglect), leading to 20 indictments for fraud and 8 for abuse and neglect. 19 cases led to fraud convictions and 6 led to convictions based on abuse and neglect. North Carolina’s MFCU recovered $53.5 million in civil and criminal settlements, with just over $3 million in grant expenditures.
June 1st, 2011
The Office of the Inspector General, U.S. Department of Health and Human Services, has launched its redesigned website. The OIG’s new site aims to be more user-friendly, with more streamlined information search and delivery. See for yourself at http://oig.hhs.gov
Also, OIG is now on Twitter. For the latest updates, you can follow the feed at http://www.twitter.com/OIGatHHS.
May 27th, 2011
Two reports issued by OIG raise concerns about security vulnerabilities in the two HHS agencies tasked with keeping electronic patient health information safe and private. The reports found that while safeguards were in place for communication between electronic health information systems, basic vulnerabilities existed in the IT systems in general, including unencrypted laptops and portable drives, unsecured networks, and outdated virus protection.
See the summaries and full text of Nationwide Rollup Review of the Centers for Medicare & Medicaid Services Health Insurance Portability and Accountability Act of 1996 Oversight and Audit of Information Technology Security Included in Health Information Technology Standards by clicking on the title of the report.
May 26th, 2011
(The titles of the bills provide links to the text. More information on the bill and its status can be found at the NC General Assembly website, here.)
HB 160 – Check Off Donation for Breast Cancer Screening Would provide space on the income tax return for individuals to make donations for early detection of breast and cervical cancer as provided by the Breast and Cervical Cancer Control Program.
HB 578 – State Health Plan/Additional Changes Would allow the State Health Plan for teachers and state employees to provide the basic plan premium-free using available cash balance reserves and would delay implementation of certain changes to the State Health Plan until September, 2011, and would grant various administrative powers.
HB 646 – Prison Hospital Completion Would provide funding to the department of correction to complete the construction of an authorized prison hospital.
HB 795 – Patient Access to Pathological Materials Would require health care providers to release pathological materials and records to patients upon written request.
HB 854 – Abortion/Women’s Right To Know Would require a twenty-four-hour waiting period and the informed consent of a pregnant woman before an abortion may be performed. “Informed consent” to include counseling and provision of information regarding the medical risks of abortion, information on the availability of assistance and adoption agencies, and ultrasound or fetal heartbeat monitoring.
SB 316 – Additional Section 1915 Medicaid Waiver Sites Would authorize DHHS to implement additional 1915(b)(c) Medicaid waiver sites and to allow state facilities to disclose certain information for purposes of collecting payment and to direct the distribution of a fund balance upon the dissolution of an area authority.
SB 246 – Expand Pharmacists’ Immunizing Authority Would expand the role of pharmacists in providing immunizations.
SB 743 – Encourage Volunteer Health Care Providers Would provide for a retired limited volunteer license and broaden the applicability of a limited volunteer license, as well as limit liability for non-profit community health referral services.
May 26th, 2011
The Centers for Medicare and Medicaid Services has made a worksheet available for providers to use in attesting the measures they are taking to meet meaningful use standards for the EHR program.
EHR is an incentive program which provides payments to eligible providers who adopt and implement certified electronic health record technology. Providers must demonstrate “meaningful use” of EHR technology.
More information on the EHR program and the attestation process can be found on the CMS EHR overview page, here; the worksheet itself can be found here.
May 25th, 2011
Ms. Skelton will be speaking to the Carolina Coders, a local chapter of the American Academy of Professional Coders (AAPC) on November 17, 2011 at Myers Park Baptist Church. Ms. Skelton will address the False Claims Act and Civil Monetary Penalties Law, with emphasis on how correct coding and billing are involved as well as the responsibility of the coder.
May 25th, 2011
Heather Skelton will be speaking to the Independent Physicians of the Carolinas on several occasions in July. Ms. Skelton anticipates speaking on the topic of negotiating managed care contracts.
Heather will speak to the physicians on July 20 in Ballantyne at 6:30 p.m.; to administrative personnel at noon on July 21 ; and to north Charlotte phyisicans on July 27 at 6:00 p.m. in Huntersville.
For more information on Independent Physicians of the Carolinas, visit their website.
May 13th, 2011
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