Category: Compliance Programs

The Joint Commission COVID-19 Information Page for Health Care Providers

Posted on by admin
The Joint Commission has issued a Coronavirus (COVID-19) guidance page for hospitals and other organizations who are accredited through that organization. The page contains a letter and a video from the CEO of the Joint Commission, Mark R. Chassin, MD, FACP, MPP, MPH. The Joint Commission Offers ...

Disclosures for Specific Payment or Health Care Operations Purposes (§ 2.33)

Posted on by admin
Part 2 Records –  Specific Payment or Health Care Operations Purposes (§ 2.33) Special restrictions apply to health information that is restricted under SAMHSA rules.  These rules protect patient information involving substance and alcohol treatment in Federal programs.  SAMHSA requirements...

Authentication of Verbal Orders by Other Responsible Practitioner

Posted on by admin
Prompt Authentication of Verbal Orders ; Verbal Order Risks The failure of a physician to timely sign a verbal order can have reimbursement implications. In some cases, in some states, another responsible provider can sign a verbal order that is originally given by another practitioner. This opti...

Telemedicine Compliance Series – Licensing Issues in Telehealth

Posted on by admin
How Telemedicine Licensing Issues Arise – Compliance for Telehealth Programs The practice of medicine is licensed and regulated at the state level.  The jurisdiction of individual states over medical licensure is broadly recognized by the courts and the federal government, including CMS.  The f...

Failing to Perform an Electronic Access Risk Analysis Before and Unauthorized Access Occurs

Posted on by admin
OCR Settlement Lessons – No Risk Assessment Exposes Provider to Liability Failure to conduct a risk assessment before a hacking incident occurred resulted in a $400,000 settlement between OCR and a Federally Qualified Health Clinic.  The FQHC filed a breach report upon learning that its employee...

Designated Health Services Definition I Stark Law DHS Defined

Posted on by admin
Definition of Designated Health Services under the Stark Law Regulations Designated health services (DHS) means any of the following services (other than those provided as emergency physician services furnished outside of the U.S.), as they are defined in this section: (1)(i) Clinical laboratory ...

Can Overpayments Create Criminal Liability?

Posted on by admin
We hear a lot about potential liability under the False Claims Act (FCA) for the failure to repay overpayments within 60 days of discovery. Focus on the 60-day rule has taken focus away from the potential for criminal charges for retaining known overpayments.  Section 1128B(a)(3) of the Social S...

Defining the Duty of the Board of Directors over Compliance Functions

Posted on by admin
Compliance Program Oversight by Board of Directors I recently posted a blog article about a document released by the Department of Justice entitled “Evaluation of Compliance Programs.”  As the title of the document might suggest, the DOJ release covers a variety of issues it looks at when ev...

Self Disclosure Process – Voluntary Self Disclosure Decisions are not Always Easy

Posted on by admin
Provider Self Disclosure Decisions – Voluntary Disclosure Process The HHS Office of Inspector General offers providers and opportunity to self-disclose certain violations in exchange for avoiding some of the more draconian penalties that may otherwise apply under applicable regulations.  Even ...