OCR Cracking Down on HIPAA Violations

The Health Insurance Portability and Accountability Act (HIPAA) has a primary goal of protecting the confidentiality and security of healthcare in formation, and has established standards for electronic data interchange (EDI). HIPAA is celebrating its twenty-first...

Compliance Corner – October

If a patient is deceased, may a covered entity disclose to a family member who was involved in the patient’s care or payment for healthcare prior to the death, PHI of the deceased? Answer: Yes, unless there is an expressed statement to the contrary. (45CR...

What to Watch Out For With Credit Balance

In May 2014, the Department of Health and Human Services, Office of Inspector General (OIG) published a proposed rule updating its regulations. The proposed rule will authorize civil monetary penalties for “failure to report and return a known overpayment,” among...

Compliance Corner: September

What are the 3 core health activities where a covered entity could disclose a patient’s PHI? Answer: The core health care activities of “Treatment,” “Payment,” and “Health Care Operations” are defined in the Privacy Rule at 45 CFR...

Medicare Guidance for Mid-Level Providers

Taking the Guesswork out of Correct Billing More and more health organizations are hiring midlevel providers to perform services that were formerly thought to be appropriate exclusively for medical physicians. While it is less costly to hire Physician Assistants,...

Compliance Corner: August

Define the principle of “minimum necessary”? Answer: a covered entity must make reasonable efforts to use, disclose and request only the minimum amount of PHI needed to accomplish the intended purpose of it’s...
Quality Measuring Tools for Payers

Quality Measuring Tools for Payers

How important is quality to you? For most people, quality – which equates to a measure of excellence and meeting strict standards – is one of the most important factors in most decision-making related to consumer goods and products. Take the automobile industry;...