Roger Steven's Blog – September 2016 Archive (9)

HIPAA has regulations concerning the use of the mobile devices to access Protected Health Information PHI). Secure technologies for communications and storage of data should also be considered when using portable technologies. Due to these requirements, the use of portable devices by patients and staff can be complex. It requires careful consideration of the…

Collections and Appeals for past due amounts can be difficult in any industry; adding the Medical Billing office element to it complicates it further. With this, one has the share of cost for patients, Medicare rules and Regulations, Private Payor contracts, and Collectors without experience in medical terminology needed for successful claims appeals to deal with.

Collections and Appeals in the medical billing office can be successful only when one has the right tools, the…

Of late, there has been an explosion in the field of biopharmaceuticals in activities ranging from development to manufacture. Although this augurs well for the industry; there are concerns, nevertheless.

These concerns relate mainly to the inadequacy of the skillsets needed for this industry. There is a widespread feeling in the industry circles that the existing or potential skillsets may not be sufficient for coping with the huge demand the industry is…

Whistleblowing is a very important area of the healthcare industry. When exercised properly and with integrity, it helps expose major frauds and saves the industry from many malpractices. There have been instances of whistleblowers bringing many companies into the legal net and helping save frauds.

A whistleblower act, or what is called or qui tam action, can offer huge financial rewards to those who are retaliated against for exposing financial fraud that their company…

Stark Law, more formally referred to as The Physician Anti-Referral Law (known as Stark II), is a prominent law concerning physician referrals. Healthcare providers that file claims require compliance with the Stark rules. Failure to comply can invite an enforcement action. The fundamental aim of this law is the elimination of malpractices in the healthcare sector. Implemented in stages known as Stark II and Stark III; the Stark Laws consider particular actions on the part of the…

The final regulations for the new HIPAA Breach Notification Rule place a far greater burden on Covered Entities and Business Associates than earlier. It is not enough for them to just notify individuals whose Protected Health Information (PHI) have been affected. For them to determine if a breach occurred, they must follow and document a very specific process. Their work does not end here. If no Breach occurred, then documentary evidence to this effect must be compiled and kept for…

The Centers for Medicare and Medicaid Services (CMS) has proposed major changes into the Conditions of Participation for Discharge Planning. These changes will have a profound effect on case management departments, which are now required to put in place a plan of action that addresses the new requirements that will affect their departments. Among the changes that will be made are out-patient discharge planning assessments, 7 days a week/24 hours a day discharge planning, and care…

The criticality of risk analysis to HIPAA implementation can be understood from the fact that inability to carry out this activity is the principal reason for which The United States Department of Health and Human Services (DHHS or just HHS) levies civil money penalties on Business Associates and Covered Entities.

This means that Covered Entities and…

With the advent of globalization, the profile and nature of spread of many infectious diseases have changed. Earlier, many infectious diseases were limited to certain specific geographical regions. But this has changed with the emergence of the globetrotter. Additional factors such as globalization of trade and commerce and global warming have contributed significantly to propelling and motivating people to travel more and more all over the world. This trend has brought about a…