Roger Steven's Blog (88)

In this age of outsourcing and globalization, and with it, the emerging potential phenomenon of the Internet of Things (IoT); it is quite a tempting proposition for HIPAA Business Associates or Covered Entities to think of outsourcing their processes relating to Protected Health Information (PHI). However, as is to be expected, there is risk involved in outsourcing this kind of critical information, given the critical importance of these healthcare records and in view of the fact that there…

MentorHealth webinars are designed to offer professionals in the healthcare industry the knowledge they need in all the areas of the healthcare industry that enables them to excel in their professions. MentorHealth’s trainings bring experts from all the core areas of healthcare and impart learning to help professionals understand and implement all the important issues that matter to their professions. To keep updating your knowledge of regulatory compliance in the healthcare industry, all…

A Claim Adjustment Reason Code (CARC) is a code used in medical billing to communicate a change or an adjustment in payment. CARCs have to be used to communicate why there was a difference between the amount paid in a claim or service line and the amount that was billed against it. CARCS are to be mentioned only if there is an adjustment of this kind. If there is no adjustment to a claim or…

One of the major fallouts of the passage of the Affordable Care Act (ACA) or Obamacare is the phenomenal rise in the number of physician practice acquisitions. These are some of the reasons for this rise:

-        Because of physician practice acquisitions, healthcare providers can consolidate and integrate their business better, since acquisition brings about alignment between the business prospects of the referral networks with the hospital’s strategic goals

-       …

The Comprehensive Error Rate Testing (CERT) is a program used by the Centers for Medicare & Medicaid Services (CMS) for calculating the rate or extent of improper payments of Medicare Fee-for-Service (FFS). The method used by the CMS under CERT is to pick up a stratified random sample of some 40,000 claims that are statistically valid and calculate and audit it to determine if the payments were made in accordance with the rules relevant to items such as coding, Medicare coverage, and…

In many years that it has been in existence, one of the noticeable changes that HIPAA has undergone is in its attitude. The earlier phase of advice and counseling has now given way to hardboiled and unforgiving enforcement. The Office of Civil Rights (OCR) no longer uses the cajoling and persuasive method. It wants to impose super harsh penalties on healthcare organizations which violate its rules.

For starters, healthcare organizations have to reckon with new, ominously higher fines,…

A HIPAA audit is very important for service providing organizations, because the penalties for violations can bring their business down. It is important to understand the nuances of a HIPAA audit if one has to be successful.

A HIPAA audit is, for many service providing organizations, a make or break situation. This is because HIPAA audits are considered stringent. Violations can attract huge penalties, which is why getting it right the first time is extremely…

For many professionals, writing skills are learned while they are on the job. In many cases, they would go by a preferred style or other documents or style guides that help to put a certain style in place. Editing, however, is rarely taught. Worse, the perception most people have of editing is that it is revising or rewriting a work. But the truth is different. Editing gives shape to a document. It helps to perfect and sculpt it. The big question most editors face…

Nanotechnology, a part of Quantum Physics (QP), is growing fast and has myriad uses. Nanotechnology is all about size and self-assembly. While QP deals with subatomic particles and waves; Nano relates to the atomic and molecular level. Atomic behavior and properties get dramatically changed at the Nano level. Of note are properties such as color change due to refraction of light. Gold, packaging and chemistry are some of the well-known areas into which…

The importance of conducting a risk analysis updating it can be gauged from the fact that failure to conduct a written risk analysis qualifies as “willful neglect”, which carries the highest Civil Money Penalty (“CMP”). This cannot be waived by the DHHS unlike violations that happen due to a reasonable cause.

Since risk analysis is a required implementation specification under the Security Rule, failure to do one amounts to willful neglect. If the civil…

A common qualifying measure of physician ability is the medical specialty board certification. Because the requirements of the board are increasing; the laws that restrict such use are on the rise.

A webinar from MentorHealth, a leading provider of professional trainings for the healthcare industry, will offer learning on the new laws and qualifications of…

What can be and cannot be done with the use of personal devices under HIPAA is something practices and businesses that need to be compliant with the provisions of HIPAA need to be thoroughly aware of.

With changes expected in 2016 relating to personal devices as well as emailing and texting; staying compliant is extremely important to protect one’s practice or…

Compliance with the Stark Law has become more than just a compliance issue. It is an Enterprise Risk Management issue, as the substantial awards and settlements in recent enforcement actions indicate. Managing their compliance and enterprise risk by ensuring that their physician employment arrangements are defensible under the Stark Law is now an…

The European Co smetics Products Regulation (EC) 1223/2009 (CPR), which became fully operational from July 2013, is a game changer in many ways, as it is considered a most contemporary regulatory framework concerning state-of-the-art of cosmetic science and product technology.

It sets out vastly harsher conditions for compliance of cosmetic products that are…

Rules implementing The Health Insurance and Portability Act of 1996 (HIPAA) and Health Information Technology for Economic and Clinical Health Act of 2003 (HITECH) underwent changes as a result of amendments brought about by the US Department of Health and Human Services in 2013.

Fundraising is among the areas of change these rules covered. Important areas…

For an organization that needs to show HIPAA compliance; having the proper policies and procedures in place is as important as ensuring that it is providing the appropriate patient rights and controls on its uses and disclosures of Protected Health Information (PHI). It makes sense for an organization that is the subject of a compliance review or is being…

The Office for Civil Rights (OCR) newly released the Phase 2 Audit Program. The audit process has started with the release of the rules and protocols. The need for a clear understanding of this new audit program by all Covered Entities (CE) and Business Associates (BA), or for that matter anyone who accesses, uses or discloses Protected Health Information (PHI) is…

Exposure to silica dust is a serious health hazard for those in construction workers and related jobs. This can result in life long disease or even death due to lung cancer. The Occupational Safety and Health Administration (OSHA) has a new regulation that deals with what employers need to do in order to prevent and offset the damage caused by extensive exposure to…

When HIPAA investigations relating to ransomware breaches find malpractices; it can be total jolt that can absolutely devastate the said practice or business. Discovery of this kind of breach during a HIPAA investigation can cause a major financial burden, apart of course, from severe embarrassment and ignominy.

This means that practices and businesses that…