COVID-19 Resources

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  1. US Food and Drug Administration closely monitoring COVID-19-related fraud

    Report on Supply Chain Compliance Volume 3, Number 15. August 06, 2020  | Author: Sascha Matuszak  | Published: August 06, 2020 

    The COVID-19 pandemic has given rise to rampant fraud in the health sector, as unscrupulous companies try to cash in on fear and a lack of certainty regarding the treatment of the virus. At the same time, many companies are pivoting to manufacture products that are in high demand during the pandemic, which carries significant compliance concerns[1] as companies enter industries with which they have little experience...

  2. Hit with Ransomware? Here's What Your Organization Is Up Against

    Report on Patient Privacy Volume 20, Number 8. August 06, 2020  | Author: Jane Anderson  | Published: August 06, 2020 

    Ransomware attacks are changing and becoming far more sophisticated, meaning hospitals and other health care entities need to step up their games to defend against these potentially crippling security events, the American Hospital Association (AHA) concluded.[1]...

  3. Privacy Briefs: August 2020

    Report on Patient Privacy Volume 20, Number 8. August 06, 2020  | Author: Jane Anderson  | Published: August 06, 2020 

    ◆ HHS changed its tone on care coordination and case management in the final Confidentiality of Substance Use Disorder Patient Records regulation (42 C.F.R. § 2), known as Part 2.[1] In the regulation, which was published in the Federal Register on July 15,[2] care coordination and case management were added to a list of 17 activities, including billing and fraud, waste and abuse activities, that now will be treated as payment and health care operations. When combined with other provisions, this means a patient can consent to share substance use disorder information with a Part 2 entity, and that entity...

  4. Ransomware Incident Security Tips

    Report on Patient Privacy Volume 20, Number 8. August 06, 2020  | Author: Jane Anderson  | Published: August 06, 2020 

    To manage a ransomware incident, Sanjay Deo, 24By7Security Inc. president and founder, recommended the following to health care entities...

  5. News Briefs: August 3, 2020

    Report on Medicare Compliance Volume 29, Number 28. August 03, 2020  | Author: Nina Youngstrom  | Published: August 03, 2020 

    ◆ The HHS Office of Inspector General (OIG) has given the green light to a plan by a charitable organization to “purchase or receive donations of unpaid medical debt owed by qualifying patients from certain types of health care providers and then forgive that debt,” according to advisory opinion 20-04.[1]...

  6. Although Audits Restart Aug. 3, CMS Will Roll Them Out in Stages; TPE Is On Ice for Now

    Report on Medicare Compliance Volume 29, Number 28. August 03, 2020  | Author: Nina Youngstrom  | Published: August 03, 2020 

    Although CMS’s website says it’s resuming Medicare audits Aug. 3, this will happen in stages. Hospitals and other providers won’t be hit with a flurry of documentation requests at the same time from CMS medical reviewers and program integrity contractors, and Targeted Probe and Educate is on hold for now, a CMS spokesperson said...

  7. Providence Settles Cases Over Exclusions for $536K; Screening Metrics May Be Helpful

    Report on Medicare Compliance Volume 29, Number 28. August 03, 2020  | Author: Nina Youngstrom  | Published: August 03, 2020 

    In a reminder that there’s a price to pay when excluded people are on your payroll, Providence Health System-Southern California and an affiliated entity agreed to settle three civil monetary penalty cases for a total of $536,148. The settlements with the HHS Office of Inspector General (OIG) stem from self-disclosures in connection with the employment of three excluded people in different facilities...

  8. Next-Generation Auditing: Analytics, Bots May Change Compliance

    Report on Medicare Compliance Volume 29, Number 28. August 03, 2020  | Author: Nina Youngstrom  | Published: August 03, 2020 

    To identify employees and vendors who could have fallen through the cracks of exclusion screening, compliance officers might periodically take a sample and run them through the HHS Office of Inspector General’s exclusion database again. This is a hit-or-miss strategy in an area with high stakes, because services provided by excluded people are not billable to federal health care programs, which is why some organizations may consider using robotic process automation instead, experts say...

  9. Telemedicine and the coronavirus crisis: Key legal issues for providers to consider

    Compliance Today - August 2020  | Author: Robin M. Singh  | Published: August 2020 

    The novel coronavirus disease (COVID-19) has affected all areas of life and healthcare delivery...

  10. Helping organizations achieve compliance in the wake of the coronavirus

    Compliance Today - August 2020  | Authors: Kimberly Gillespie, Henry C. Fader  | Published: August 2020 

    In response to the COVID-19 pandemic in the first half of 2020, the healthcare industry responded on many levels to help communities and save lives. To support this extraordinary effort, federal and state governments released numerous guidelines, directives, rules, Q&As, and regulations to remove barriers standing in the way of patient care at a time of national crisis. Many of these initiatives relaxed or countermanded policies, procedures, and accrediting standards, in all levels of care, including hospitals, skilled nursing facilities, and telehealth. Over time, however, we expect many of these initiatives to further morph and/or unwind. This will be challenging...

  11. OSHA releases revised COVID-19 guidance

    Compliance Today - August 2020  | Author: Sascha Matuszak  | Published: August 2020 

    The Department of Labor’s Occupational Safety and Health Administration (OSHA) released revised guidelines regarding enforcement actions during the COVID-19 pandemic.[1] There are two major changes: increasing in-person inspections as noncritical businesses start to reopen and requiring businesses to treat the coronavirus as a reportable illness during recordkeeping...

  12. COVID-19: Into the unknown

    Compliance Today - August 2020  | Author: Jay P. Anstine  | Published: August 2020 

    From scheduling patients to care delivery to reimbursement, healthcare is an industry functioning on a daily basis under highly technical processes and a mountain of regulations. Generally speaking, privacy professionals can serve to support leadership as they navigate these operational challenges with respect to protected health information (PHI). In this strange new world of COVID-19, there has been no shortage of opportunities to consult leaders on issues such as media access to PHI, safeguarding PHI with a remote workforce, and appropriate sharing of test results. While this list is not intended to be exhaustive, these are some issues you’ve encountered...

  13. Balancing privacy, ethics, and safety during COVID-19

    CEP Magazine - August 2020  | Authors: Brian Lee, Dian Zhang  | Published: August 2020 

    As companies bring employees back to the workplace, many have embraced the once-unpopular decision of collecting employee health data. In June, 59% of 104 legal leaders Gartner polled said they had begun or were considering collecting employees’ self-reported symptoms assessment; more than 50% are doing the same with temperature data.[1] The numbers are likely higher now...

  14. Small Business Administration scrapped ethics review for COVID-19 payments

    ethikos Volume 34, Number 8. August 01, 2020  | Published: August 01, 2020 

    The United States Small Business Association (SBA) scrapped a requirement that had loan seekers undergo an ethics review before obtaining funds from the Payment Protection Program (PPP).[1]...

  15. Preparing for the era of provider network transparency

    Compliance Today - August 2020  | Authors: Michael Adelberg, John Weis  | Published: August 2020 

    Transparency is one of the top buzzwords in healthcare today. In the last few years, we have seen the rollout of significant healthcare transparency initiatives focused on portable health records, hospital costs, drug costs, quality data, and many other things (e.g., Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First).[1] And yet, with a good deal less fanfare, healthcare policymakers have also put in place the changes necessary to usher in a new era in health plan provider networks—the era of provider network transparency. In the following paragraphs, we discuss the coming of provider...

  16. The Provider Relief Fund: Welcome relief or compliance minefield?

    Compliance Today - August 2020  | Authors: Andrew B. Wachler, Stephen J. Shaver  | Published: August 2020 

    The outbreak of COVID-19 has sent shock waves through the US economy. In the healthcare industry, hospitals and healthcare providers have seen nonessential but revenue-generating procedures postponed and distancing guidelines lead to steep declines in other services.[1] At the same time, they have seen a surge in actual and potential COVID-19 patients, as well as rapid increases in the prices of many basic medical supplies and equipment.[2] Caught between sudden expenses and a sudden drop in revenue, many hospitals and healthcare providers are struggling for operating capital[3] and some have shut down entirely.[4]...

  17. Conduct a legal premortem to identify and mitigate risk before a crisis

    CEP Magazine - August 2020  | Author: Jonathan Aronie  | Published: August 2020 

    More than 2,000 years ago, a Jewish sage living in Jerusalem compiled a book of wisdom today known as Ecclesiasticus.[1] The book was translated from Hebrew to Greek by the author’s son around 130 BC, and much later, the book was translated into English. Among the aphorisms that find their origin in this ancient text is one we’ve all heard before: haste makes waste. In the late 1700s, Napoleon Bonaparte is said to have remarked to his valet as he prepared for battle, “dress me slowly; I’m in a hurry.” We don’t know whether Napoleon had read Ecclesiasticus (Napoleon generally...

  18. Comfortable comfort in compliance

    Compliance Today - August 2020  | Author: Nancy J. Beckley  | Published: August 2020 

    This year may be best described as “the year of living dangerously,” as we get ready to end the summer and look forward to a Labor Day weekend that signals the march to the end of the year. The disruption caused by the new skilled nursing facilities’ Patient-Driven Payment Model and the new home health Patient-Driven Grouping Model gave way to COVID-19 and helped declare a pandemic and a public health emergency...

  19. Uptick in fraud leads to increased whistleblower complaints in US

    CEP Magazine - August 2020  | Author: Sascha Matuszak  | Published: August 2020 

    The United States Securities and Exchange Commission (SEC) reported a 35% increase in complaints from mid-March to mid-May compared with last year. The increase is due to two distinct factors[1] : the widespread fraud due to COVID-19 and the willingness of now-unemployed workers to come forward with complaints...

  20. Compliance program (and officer) effectiveness in a time of crisis

    Compliance Today - August 2020  | Author: Matthew D. Vogelien  | Published: August 2020 

    I had the pleasure of hearing Tammie Jo Shults speak at one of our organization’s leadership events. You may not remember her name (she prefers it that way, because she is a very humble person), but you likely remember her story. On April 17, 2018, an engine on the plane she was flying exploded, spraying shrapnel that blew out a window.[1] One passenger died, and several others were injured. In the midst of chaos and fear in the cabin, Tammie Jo calmly coached her crew and completed an emergency landing to save the lives of 148 people. When our CEO...

  21. Integrating telehealth into compliance programs: Best practices for compliance professionals

    Compliance Today - August 2020  | Authors: Nick Merkin, Erin MacLean  | Published: August 2020 

    Even before many Americans were affected by the novel coronavirus and the resulting stay-at-home orders, school closures, and business shutdowns, telehealth was one of the fastest-growing segments of healthcare. Telehealth, a broadly defined term, includes the remote delivery of care by medical professionals, along with an array of services and technologies, such as artificial intelligence, virtual reality, and other interactive platforms.[1] Telehealth’s potential to expand access to care at reduced cost while maintaining high standards of quality is well suited for today’s value-based care models. Additionally, as a solution to overcrowded emergency rooms and expensive clinic space, many healthcare providers...

  22. Where do I fit in? The role of the CCO in a pandemic

    Compliance Today - August 2020  | Author: Joshua A. Boxer  | Published: August 2020 

    Being a chief compliance officer (CCO) can sometimes be a thankless job. CCOs can be perceived as “police,” “internal affairs,” and “deal killers” by colleagues. “Here comes compliance.” CCOs know that this is generally untrue. Personally, I take offense to such stereotypes, although I understand the root of such thoughts. I pride myself on being a practical, business-minded CCO. While I am not afraid to take an unpopular opinion, my go-to problem-solving method is resolving compliance inquiries in a collaborative and amicable fashion. Obviously, it is not always possible. Compliance with healthcare regulations and business strategy are not mutually exclusive,...

  23. Meet Gabriela Behn: Prioritizing healthcare access

    Compliance Today - August 2020  | Author: Margaret Hambleton  | Published: August 2020 

    MH: Compliance programs in public entities are very different from nonpublic entities in many ways and very similar in other ways. Can you tell our readers about your background, your current position at San Mateo Medical Center (SMMC), and how you developed your compliance program to address the unique risks for a public safety net hospital?...

  24. Is your cyber insurance enough?

    CEP Magazine - August 2020  | Author: Erich Kron  | Published: August 2020 

    Let’s talk for a moment about the exciting world of cyber insurance. Well, I suppose it’s not really that exciting until things go wrong, but it does need some discussion given the recent events around the ransomware industry...

  25. The power of persuasion

    Compliance Today - August 2020  | Author: Gerry Zack  | Published: August 2020 

    Have you ever rolled out a new policy, procedure, or internal control, only to have it met with skepticism and a chorus of “Why do we have to do this?” Of course you have; we all have. Yet we sometimes still fail to understand why people ask it...