Healthicity Blog

For calendar year 2017, the Centers for Medicare & Medicaid Services (CMS) have finalized updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System.

Most doctors read medical journals to stay abreast of the most current treatment options or cutting edge research about advancements in clinical care. And more and more physicians are seeing articles in their medical journals about compliance, fraud and abuse.

In this episode of Compliance Conversations, Cj Wolf sits down with Security and Privacy expert, Steve Spearman, to chat about ways healthcare practices can protect themselves from security and privacy threats.

One of the very first HIPAA Security regulations is, “Assigned Security Responsibility” 164.308(a)(2). This regulation requires every Business Associate and every covered entity to have a designated HIPAA Security Officer.

1. Federal prosecutors accuse local medical practice of fraud - “A local medical group that treats patients with cancer and blood disorders took illegal kickbacks and filed false Medicare claims, according to a complaint filed by federal prosecutors…Prosecutors allege two illegal schemes.

In Medicare and Medicaid services, managed care plans fall under Part C, a Medicare Advantage plan alternative to Parts A and B. Medicare Advantage plans often include integrated self-administered drug coverage similar to the standalone Part D prescription drug benefit plan.

Many of us have heard the phrase that those who cannot remember the past are condemned to repeat it. It seems this is proving true with a couple of recent healthcare compliance settlements.

What is 1557 and Why Comply?

Section 1557 builds on prior federal civil rights laws to prohibit sex discrimination in health care.