COVID-19 Resources

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  1. New and Revised Telehealth Place-of-Service Codes Change Reporting for Patients at Home

    Report on Medicare Compliance Volume 30, Number 37. October 18, 2021  | Author: Nina Youngstrom  | October 18, 2021 

    Paving the way for better reporting of telehealth services provided to patients at home and the permanent coverage of telebehavioral health, CMS has created a new place-of-service (POS) code and revised another, according to Medicare Transmittal 11045, which was posted Oct. 13.[1] The codes have implications for telehealth during and after the COVID-19 public health emergency (PHE)...

  2. With Difficult Patients, Providers Balance Legal Risks, Safety

    Report on Medicare Compliance Volume 30, Number 37. October 18, 2021  | Author: Nina Youngstrom  | October 18, 2021 

    A hospital is in a bind when an inpatient demands a treatment that the care team doesn’t think is medically appropriate and may be dangerous, while refusing to agree to the course suggested by the care team that would allow for safe discharge. It’s one example of difficult patient situations that require hospitals and other providers to navigate their ethical and legal obligations to patients while protecting the safety of their employees and other patients, attorneys say...

  3. FBI Says More Due Diligence Needed To Fight China in Data ‘Space Race’

    Report on Medicare Compliance Volume 30, Number 37. October 18, 2021  | Author: Theresa Defino  | October 18, 2021 

    Conducting a risk analysis is a basic tenet of security compliance, with the overarching goal of understanding where protected health information (PHI) “lives” in an organization, where it moves, where it resides—and then implementing safeguards. Would China be an acceptable final resting place? And would covered entities (CEs) or business associates (BAs), with their often murky subcontractors, even know if the Chinese government was tapping into it?...

  4. The Wait Is Over: HHS’s Choice to Run OCR Has Breach, Federal Leadership Experience

    Report on Patient Privacy Volume 21, Number 10. October 14, 2021  | Author: Theresa Defino  | October 14, 2021 

    For the past year, Lisa J. Pino, President Biden’s new choice to lead the HHS Office for Civil Rights (OCR), was the number two health official in the New York State Department of Health.[1] Pino’s career also includes helping to manage the aftermath of the 2015 breach of millions of records maintained by the Office of Personnel Management (OPM)...

  5. Privacy Briefs: October 2021

    Report on Patient Privacy Volume 21, Number 10. October 14, 2021  | Author: Jane Anderson  | October 14, 2021 

    ◆ A massive data breach at University of New Mexico (UNM) Health may have allowed a third party to obtain medical records from more than 600,000 patients—more than a quarter of the state’s population. UNM Health has been mailing letters to affected patients who had been treated at either UNM Hospital, UNM Medical Group or the UNM Sandoval Regional Medical Center, hospital officials said. The breach occurred on May 2 and was discovered on June 4, according to UNM Health’s statement. Patient names, medical record numbers and Social Security numbers were among the information obtained during the data breach, said...

  6. FBI: More Awareness, Due Diligence Needed To Fight China in New ‘Space Race’ for Data

    Report on Patient Privacy Volume 21, Number 10. October 14, 2021  | Author: Theresa Defino  | October 14, 2021 

    Conducting a risk analysis is a basic tenet of security compliance, with the overarching goal of understanding where protected health information (PHI) “lives” in an organization, where it moves, where it resides—and then imposing safeguards. Would China be an acceptable final resting place? And would covered entities (CEs) or business associates (BAs), with their often murky subcontractors, even know if the Chinese government was tapping into it?...

  7. CMS Cites EMTALA Obligations Around Pregnancy; Waivers May Be a Risk in States Without PHE

    Report on Medicare Compliance Volume 30, Number 36. October 11, 2021  | Author: Nina Youngstrom  | October 11, 2021 

    In a September 17 memo, CMS reminded hospitals of their obligations to “patients who are pregnant or are experiencing pregnancy loss” under the Emergency Medical Treatment and Labor Act (EMTALA), a move seen as a message to providers in Texas, which enacted a near total ban on abortion, and other states, such as Mississippi, that have sharply restricted access to abortion.[1]...

  8. OCR: HIPAA Doesn’t Preclude Vaccine Question, It Protects the Answer

    Report on Medicare Compliance Volume 30, Number 36. October 11, 2021  | Author: Nina Youngstrom  | October 11, 2021 

    There’s nothing stopping hospitals and other providers from asking patients whether they’ve been vaccinated for COVID-19 under HIPAA. Patients don’t have to answer, but if they do, the privacy rule kicks in, according to new guidance from the HHS Office for Civil Rights (OCR).[1] By the same token, HIPAA doesn’t apply to employment records or have anything to say about employer vaccination mandates and related documentation requirements...

  9. News Briefs: October 11, 2021

    Report on Medicare Compliance Volume 30, Number 36. October 11, 2021  | Author: Nina Youngstrom  | October 11, 2021 

    ◆ Correction: In the Oct. 4 print edition of RMC, the story on expedited appeals refers to a town hall sponsored by the American College of Emergency Physicians, but it was actually sponsored by the American College of Physician Advisors...

  10. More Providers Settle CMP Cases Over PRF; OIG: Attestations Had False Information

    Report on Medicare Compliance Volume 30, Number 35. October 04, 2021  | Author: Nina Youngstrom  | October 04, 2021 

    Two more providers have settled allegations they made false statements to get money from the HHS Provider Relief Fund (PRF), the HHS Office of Inspector General (OIG) said...

  11. News Briefs: October 4, 2021

    Report on Medicare Compliance Volume 30, Number 35. October 04, 2021  | Author: Nina Youngstrom  | October 04, 2021 

    ◆The HHS Office for Civil Rights on Sept. 30 released guidance on “HIPAA, COVID-19 Vaccination, and the Workplace.”[1] Among other things, the guidance explains that the HIPAA privacy rule doesn’t prohibit “a covered entity or business associate from requiring its workforce members to disclose to their employers or other parties whether the workforce members have received a COVID-19 vaccine.” The reason: “The Privacy Rule does not apply to employment records, including employment records held by covered entities and business associates acting in their capacity as employers.”...

  12. MA Expedited Appeals Reverse Many Pre-Service Denials; Door May Open to Patient Status

    Report on Medicare Compliance Volume 30, Number 35. October 04, 2021  | Author: Nina Youngstrom  | October 04, 2021 

    A Medicare Advantage (MA) plan’s refusal to authorize inpatient rehabilitation for a patient with a bilateral amputation and active anemia is the kind of case that drives the use of expedited appeals. The MA plan told the hospital the medical complexity wasn’t there for acute rehabilitation, but its decision was reversed with an expedited appeal to the independent review entity for Medicare Part C...

  13. CARES Act: More time for using and reporting provider relief funds

    Compliance Today - October 2021  | Author: Marti Arvin  | October 2021 

    On June 11, 2021, the U.S. Department of Health & Human Services provided welcome news to recipients of the Coronavirus Aid, Relief, and Economic Security (CARES) Act provider relief funds (PRFs).[1] The notice provided updated timelines for recipients of PRFs regarding both using the funds and reporting on the use of the funds. The original deadline for using funds was December 31, 2020. The original reporting deadline was February 15, 2021. The Department of Health & Human Services did allow additional time for entities that did not use all of the funding received by December 31, 2020, until July 31,...

  14. Remote monitoring

    Compliance Today - October 2021  | Author: John Falcetano  | October 2021 

    Since the beginning of the COVID-19 pandemic, many compliance professionals have found themselves working remotely. Today’s technological advances allowing for remote access to electronic health records and virtual meeting capabilities have enabled compliance professionals to successful maintain an effective compliance program. Compliance professionals have realized they do not need to maintain an office at their organization to be successful. Compliance is joining many other organizational operations as healthcare leaders redesign the way they do business...

  15. Meet Emmelyn Kim: Never stop learning

    Compliance Today - October 2021  | Author: Adam Turteltaub  | October 2021 

    AT: A lot of people end up in compliance or an industry. Life sort of just takes them there. As I was preparing for this interview and learning about you, it struck me that you seemed destined to be here. Healthcare has been the focus of your entire career, starting with college, where you studied psychology and biology. What attracted you to the healthcare field?...

  16. Partnering marketing and privacy to develop a proactive privacy program

    Compliance Today - October 2021  | Authors: Lisa Taylor, Daniel S. Elmlinger  | October 2021 

    Privacy programs need to take the pulse on what is going on in their organizations, but some programs may struggle to keep up with their organizations’ initiatives. Put simply, there is a limited number of people in privacy programs (sometimes only one person or a fraction of a full-time equivalent) but a multitude of information and ideas being exchanged across the organization. Sometimes privacy may get pulled into an idea or issue too late, or sometimes not until after a decision has been made, and then weeks, months, or maybe even years of work and procedures must be undone in...

  17. Legacy data management and compliance: Prepare your business today

    Compliance Today - October 2021  | Author: Bridget Group  | October 2021 

    In recent years, it has become easier than ever before for people to share information and ideas instantly. Whether through a text, email, or other platform, technological advances make this kind of sharing possible. When it comes to the healthcare industry, the focus on interoperability and value-based care requires patients, physicians, and vendors to seamlessly share data and information in a productive, compliant way...

  18. What you need to know to provide transitional care management services

    Compliance Today - October 2021  | Authors: Christine Davenport, Monica Alexanderson  | October 2021 

    Did you know there is a way to help avoid unnecessary inpatient readmissions and be reimbursed for providing post-discharge professional services to your patients? The Centers for Medicare & Medicaid Services (CMS) developed Transitional Care Management (TCM)[1] codes in recognition of care coordination that can improve patient care, enhance quality of life, and reduce healthcare costs. The TCM service focuses on the handoff between an inpatient setting and the community setting with a goal of avoiding unnecessary readmissions. Sounds good, right?...

  19. Building a new research compliance program: Where do I begin?

    Compliance Today - October 2021  | Authors: Tracy L. Popp, Lynn E. Smith  | October 2021 

    One of the hallmarks of a high-performing clinical research program is a robust research compliance partner. If you have the opportunity to build a new clinical research program, be sure to include a research compliance office in the design to work hand in hand with the clinical research staff. If you manage a clinical research program that lacks a research compliance partner, or a clinical research program with an ineffective or incomplete research compliance component, it is time to make a case to senior leadership of the importance of having this valuable partner...

  20. Three tips to host successful risk assessment workshops

    CEP Magazine - October 2021  | Author: Dian Zhang  | October 2021 

    Risk assessment workshops are an effective way for compliance departments to identify emerging risks and uncover blind spots in mitigation plans. Unlike surveys, a workshop allows participants to respond to detailed scenarios and follow-up questions. It also helps compliance teams hear from many people at once without a heavy investment of time in one-on-one interviews...

  21. From apathy to advocacy: Germany’s growing support for compliance programs

    CEP Magazine - October 2021  | Author: Nicole Willms  | October 2021 

    Compared to other jurisdictions, first and foremost the United States, compliance management is a fairly new corporate governance topic among German companies. For decades the concept of compliance was a “legal transplant” mainly recognized and taken seriously by large global companies having to comply with foreign standards. Lately, however, more and more increasingly complex compliance requirements are finding their way into German law, becoming applicable for medium-sized and even smaller German companies. Maintaining an adequate compliance program is evolving from a best practice fiduciary measure of self-control and protection of a company’s assets and reputation to a legally promoted instrument...

  22. I-9 Compliance with an Increasingly Remote Workforce

    2021 SCCE Webinar  | September 2021 

    • Unique challenges for completing Forms I-9 for remote workers

    • Covid-19 I-9 flexibility and limitations

    • Implications forI-9 compliance violations and best practices for audits

  23. Hospital Settles CMP Case Over Billing HRSA Without COVID-19 as Primary Diagnosis

    Report on Medicare Compliance Volume 30, Number 34. September 27, 2021  | Author: Nina Youngstrom  | September 27, 2021 

    In a case that illuminates another billing risk unique to pandemic times, Midland Memorial Hospital in Texas has agreed to pay $555,141 in a civil monetary penalty settlement over claims for uninsured COVID-19 patients submitted to the Health Resources and Services Administration (HRSA)...

  24. News Briefs: September 27, 2021

    Report on Medicare Compliance Volume 30, Number 34. September 27, 2021  | Author: Nina Youngstrom  | September 27, 2021 

    ◆ The HHS Office of Inspector General (OIG) has posted a request for information from the industry on how it uses OIG resources and how OIG could improve the value and timeliness of resources and their accessibility and usability.[1] OIG specifically is asking for feedback on advisory opinions, fraud alerts, special advisory bulletins, compliance program guidance, frequently asked questions, other compliance guidance and resources, corporate integrity agreements, the list of excluded individuals/entities, and audits and evaluations...

  25. Moving the Goalpost on Nurse Staffing Requirements

    2021 HCCA Webinar  | September 2021 

    • Gain an in-depth understanding of Payroll-Based Journal Data and how it is utilized by government enforcement agencies and in patient care cases

    • Learn about Plaintiff's staffing theories and attempts to assign a higher staffing level based on acuity or the CMS "expected staffing" model in LTC centers

    • Develop strategies to combat Plaintiff's attempts at heightened nurse staffing theories