Wisconsin Physician Services (WPS) issued guidance yesterday clarifying the importance of physician signatures on dictated notes, which emerged as a national issue identified by the Comprehensive Error Rate Testing Program (CERT). Regardless of whether dictation is given directly to a scribe, or via an electronic recording that is then transcribed, physicians must review the record […]
In Little Rock, Arkansas, Dr. Jay Holland, Sarah Miller, and Candida Griffin were sentenced this week for violating the Health Insurance Portability and Accountability Act (HIPAA). According to the U.S. Department of Justice press release, the three individuals plead guilty on July 20, 2009 “to misdemeanor violations of the health information privacy provisions [of HIPAA] […]
Representative John Adler’s proposed Red Flags exceptions–H.R. 3763–passed in the House on October 23. Passing with a 400-0 vote, the bill exempts small businesses with 20 or fewer employees that meet certain requirements. The bill will next be sent to the Senate for vote. Notwithstanding this legislation, the Red Flags Rule is still set to […]
Representative John Adler introduced H.R. 3763 on October 8 to amend the definition of “creditor” in the Fair Credit Reporting Act to reflect the following exclusions: (A) a health care practice with 20 or fewer employees; (B) an accounting practice with 20 or fewer employees; (C) a legal practice with 20 or fewer employees; or […]
Alleging False Claims Act, Stark Law, and Anti-Kickback violations, the University of Medicine and Dentistry of New Jersey (UMDNJ) settled with the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) for $8.3 million–double what Medicare paid for the allegedly improper referrals. UMDNJ is licensed as a Level I Trauma Center. […]
The OIG released its Work Plan for the 2010 fiscal year (FY) this week, to be effective beginning October 2009. The OIG’s Work Plan “describes the specific audits and evaluations that [the OIG has] underway or plan[s] to initiate in the FY ahead….The Work Plan also provides focus areas for [the OIG’s] investigative, enforcement, and […]
When a beneficiary elects hospice care, s/he waives any Part B coverage related to that hospice care except for services rendered by an “attending physician.” An attending physician is defined as either a doctor of medicine, doctor of osteopathy or a nurse practitioner who is identified by the beneficiary as having the most significant role […]
On September 22, 2009, the U.S. Senate’s Chairman’s Mark released a draft legislation regarding the future of healthcare in the United States. Some notable points include: – Limiting physician referrals only to permit hospitals that meet certain exemption requirements, which would be more stringent than the current Medicare requirements; – Establishing a process to update […]
Arizona Heart Hospital agreed to settle with the Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) for $675,000 for 10 instances of filing false claims with Medicare. According to the OIG and HHS, between July 2005 and March 2007, physicians at Arizona Heart Hospital submitted claims for carotid artery […]
OIG released two reports examining the hospice benefit for residents of a nursing care facility. The first report, “determined the extent to which hospice claims for beneficiaries in nursing facilities met Medicare coverage requirements.” According to Section 418 of Title 42 of the Code of Federal Regulation, to receive Medicare coverage for delivering hospice care […]
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