Healthicity Blog

Q1: What do you know about this new HIPAA Audit program?

As a Compliance Officer, you’re charged with the complicated task of creating and maintaining compliance. You manage a thousand moving parts, often while fighting a constant, uphill battle to prove the legitimacy of your relatively new, though crucial, position.

Recently, federal auditors reported that the University of Minnesota Medical Center needs to refund more than $3.2 million in estimated overpayments for services that were allegedly billed incorrectly to the Medicare program.

It’s crucial to perform a medical records audit to effectively maintain your auditing plan. Reporting results to the overseeing physicians, committee, or board is the next step to improving organizational compliance.

"A Code of Conduct is fundamental to a successful compliance program because it articulates the organization’s commitment to ethical behavior.”

Organizations that fail to report overpayments within 60 days can be liable under the False Claims Act and may be subject to civil/criminal liabilities.

Compliance can be complicated: Keeping up with regulations, protecting your organization from loss of profit or even legal actions.

In the past few years there has been a steady increase in HIPAA violations surrounding privacy and security, many as a result of the HIPAA Omnibus rule that took effect in 2013.