For much of healthcare, HIPAA sets the standards for how to manage uses and disclosures of patient information, known as Protected Health Information (PHI). But when it comes to information related to the treatment of substance use disorders, regulations of the Substance Abuse and Mental Health Services Administration (SAMHSA) under 42 CFR Part 2 prevail. … Continue reading HIPAA and 42 CFR Part 2: Managing Health Care and Substance Use Disorder Information→
HIPAA audits and enforcement are now a significant reality, and settlements for violations are being announced for more violations regularly. Now, with the increases in breach reporting and the HIPAA random audit program, enforcement of HIPAA is something that every HIPAA entity and business associate needs to be aware of and prepared for, by taking the … Continue reading HIPAA Audits and Enforcement Updates→
Enrolling with the Medicare program involves the various CMS-855 forms. There are now seven different forms that must be used by different providers of healthcare services or products. These forms are long, detailed and sometimes confusing. Not only must they be filed initially for a given provider, they must be maintained and updated as appropriate. … Continue reading Medicare Enrollment Update for 2018: Updates on CMS – 855 Forms→
Physician Arrangement Auditing and Monitoring This is a walk-through of prime tools you would need in order to conduct a review of physician arrangements (especially with in a hospital setting); what core questions should be included in this review; and how to report within provider’s environment based on a challenging regulatory environment. The Department of … Continue reading Physician Arrangement Auditing & Monitoring→
Medical Office Compliance Planning Medical Offices continue to face the ever-growing compliance requirements of government laws, regulations, rules, and guidelines. To be prepared and properly trained in compliance, medical practices need staff who can develop, organize, manage, and direct the roles and responsibilities of a compliance department. The Patient Protection and Affordable Care Act (PPACA) … Continue reading Effective Compliance Planning for Your Medical Practice→
Healthcare compliance programs have been around for more than 20 years. Initially, they were voluntary unless a settlement agreement with the government or the OIG resulted in a corporate integrity agreement which required a compliance program. However now, the Affordable Care Act requires participants in federal health care programs such as Medicare to have a … Continue reading How To Start A Healthcare Compliance Programs→
The HIPAA Privacy, Security and Breach Notification Rules require covered entities and their business associates to safeguard electronic protected health information (ePHI) through reasonable and appropriate security measures, and make the appropriate notifications when a breach of the privacy or security of ePHI occurs. Suffering through a breach incident costs money, takes time, and diverts … Continue reading Avoiding HIPAA Breaches – Steps to Take to Protect Your Office→