Roger Steven's Blog (88)

The combination of the implementation of new HIPAA regulations in the HIPAA Omnibus Update of 2013 and increased enforcement and audit activity has forced healthcare organizations to review their compliance and to ensure that they have the proper policies, procedures, and forms in place. Because of this, HIPAA Privacy Officers have been renewing their compliance activities and reviewing their documentation to make sure they can meet…

The various programs of the CMS, such as Quality Payment Program, MACRA, MIPS and APM incentive implementation need to be given close attention if these programs have to be properly implemented. Healthcare professionals have to pay thorough and full attention to the structure and program-specific details.

This is the right time to start preparing, because the…

All the major players in an organization that is required to carry out HIPAA audits, such as information technology managers, business managers and compliance officers, have to be conversant with all aspects of the HIPAA Security Rule as it relates to portable devices. They need to be thoroughly clear about all areas such as…

Healthcare providers have to pay close attention to the structure and program-specific details on CMS's Quality Payment Program, MACRA, MIPS and APM incentive implementation. Since the first performance year for these programs begins on January 1, 2017 and payment adjustments will follow in 2019 (as the 2019 bonus/penalty adjustments will be based on the 2017…

A very big misconception in the field of medicine is that biomedical writing is highly technical and replete with jargon, and therefore not creative. There is enough scope in biomedical writing for creativity and the use of artistic and imaginative words without compromising on the meaning or import of the words. In fact, resorting to the use of imaginative words…

Practice managers, business managers and compliance officers need to have all their points in order before a HIPAA audit. They need to be fully educated about the misconceptions and realities of a HIPAA audit, since there is a lot of misinformation about HIPAA that keeps doing the rounds most of the time. These professionals who deal with HIPAA audits for their…

The Anti-Kickback and Stark Law is a vital Act for healthcare practitioners, and it includes several changes for 2016.

Is the implementation of the Stark Law important? It is much more than being just important. It is critical. The reason for this is that lack of proper implementation of this law in its entirety attracts substantial awards and settlements, as…

An organization that needs to be HIPAA compliant has to not only ensure that it provides the appropriate patient rights and controls on its uses and disclosures of Protected Health Information (PHI); it has to also have the proper policies and procedures in place. Any organization that is the subject of a compliance review or is being audited has to demonstrate to the government that it has both the documentation necessary for safeguarding patient PHI, as well as the ability to show…

Any healthcare organization that is active on the social media is vulnerable to some or another kind of Protected Health Information (PHI) breach. Although a healthcare practice or business benefits greatly in terms of marketing and publicity from the judicious use of the social media for; data stored on Facebook, LinkedIn, YouTube or Instagram leaves it susceptible…

An organization that needs to be HIPAA compliant has to not only ensure that it provides the appropriate patient rights and controls on its uses and disclosures of Protected Health Information (PHI); it has to also have the proper policies and procedures in place. Any organization that is the subject of a compliance review or is being audited has to demonstrate to…

Healthcare computer systems implementation can be anything from a headache to nightmare, given its complexity. Things can go wrong at any stage and for any reason. Getting the computer systems right or implementing the right one involves investment of considerable time and money from all kinds of healthcare organizations, big or small.

Fortunately, many of…

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…