Medicare, Medicaid & Private Payor Updates

Responding to a Texas Medical Board Complaint

(July 7, 2014): The Texas Medical Board (Board) investigates complaints against physicians, physician assistants, acupuncturists and surgical assistants. A Texas Medical Board complaint can be filed by a patient, a patient’s family or a health care provider. On the average, the Board receives and evaluates over 7,000 complaints each year. The kinds of violations the […]

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The Cloud Storage of Medical Records Presents a Number of Risks

(July 3, 2014): The growing trend of storing all kinds of data in the cloud comes with benefits and risks. However, when it comes to storing medical records in to the cloud, patient privacy becomes a special concern. With a properly implemented cloud storage system, hospitals can share information far more efficiently. Prescriptions and test

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Physician Office OSHA Standards Present a Number of Compliance Challenges

(July 2, 2014): The Occupational Safety and Health Administration (OSHA) is an agency of the United Stated Department of Labor. Its purpose is assure safe and healthy working conditions for all working men and women by setting and enforcing standards and by providing education, training, outreach, and assistance. OSHA creates standards and guidelines that apply

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Texas H.B.300 Imposes a Number of New Medical Privacy Requirements

(June 30, 2014): The federal Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH) work in conjunction to safeguard the privacy of patient health information. Concerned that HIPAA and HITECH did not provide enough safeguards for protected health information (PHI), the Texas legislature passed the Texas

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Miscoded Evaluation and Management Services Cost Medicare $6.7 Billion

(June 25, 2014) Officials at the Department of Health and Human Services, Office of Inspector General (OIG) recently examined medical records from 2010 for claims related to evaluation and management services (E/M services). The results are astounding. OIG determined that Medicare inappropriately paid $6.7 BILLION for E/M services that year due to claims that were

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Consequences of HIPAA Non-Compliance

(June 16, 2014): It has been over a year since the effective date of the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) comprehensive modifications to the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, Enforcement and Breach Notification Rules, commonly referred to as the Omnibus Rule. Covered entities were

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HIPAA Encryption is the Best Way to Avoid a Violation

(May 29, 2014): On April 22, 2014, the U.S. Department of Health and Human Services Office for Civil Rights (HHS-OCR) announced that it had entered into resolution agreements with two entities for $1,725,220 and $250,000, respectively, to resolve potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. The main

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Texas Providers Are Required by Law to Have a Medicaid Compliance Program

(February 21, 2014): If you are a participating provider in the Texas Medicaid program, do you have a Medicaid compliance program in place for your practice? If the answer to this question is “no” – or, more worrisome, if you are asking, “What is an effective compliance program?” – you are violating the terms of

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CMS and Contractors Must Address EHR Fraud Vulnerabilities

(February 7, 2014): A new report from the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) finds that the Centers for Medicare and Medicaid Services (CMS) and its contractors have adopted few Medicare program integrity practices to address electronic health record (EHR) fraud vulnerabilities. These EHR fraud vulnerabilities include

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