COVID-19 Resources

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  1. Commercial Payer, Medicare Telehealth Audits Are Underway, With Some Surprises

    Report on Medicare Compliance Volume 30, Number 2. January 18, 2021  | Author: Nina Youngstrom  | January 18, 2021 

    In an audit twist that shows the prevalence of telehealth services because of COVID-19, some reviews are underway of in-person home infusion, with auditors questioning why home infusion physician practices aren’t delivering more follow-up services by telehealth, an attorney said...

  2. CMS to Take Back Money It Returned Under Site-Neutral Payment Policy

    Report on Medicare Compliance Volume 30, Number 2. January 18, 2021  | Author: Nina Youngstrom  | January 18, 2021 

    CMS is taking back money from hospitals for outpatient clinic visits provided in 2019 at excepted off-campus provider-based departments (PBDs) after returning the money when it lost a federal court decision on the site-neutral payment policy introduced in the 2019 Outpatient Prospective Payment System regulation...

  3. Outlook 2021: COVID-19 Will Shape Compliance Agenda; Other Challenges Also Loom Large

    Report on Medicare Compliance Volume 30, Number 1. January 11, 2021  | Author: Nina Youngstrom  | January 11, 2021 

    The COVID-19 pandemic will continue to set the agenda in compliance and enforcement in 2021 without swallowing it whole. It will be the year of duality, as the virus rages on but vaccines put the nation on the road to recovery, as auditors and enforcers pursue both COVID-19 abuses and more familiar types of overpayments and fraud, and as compliance professionals who are working remotely put one foot back in the office, which may be smaller as some hospitals reduce their real estate footprint. Wherever they are, compliance professionals will have a lot on their plate. New regulations take effect...

  4. CMS Transmittals and Federal Register Regulations, Dec. 18, 2020-Jan. 7, 2021

    Report on Medicare Compliance Volume 30, Number 1. January 11, 2021  | January 11, 2021 

  5. Outlook 2021: Expect 'Vigorous' FCA Enforcement; Prosecutor: Don't Back Off Compliance

    Report on Medicare Compliance Volume 30, Number 1. January 11, 2021  | Author: Nina Youngstrom  | January 11, 2021 

    Although there will be new leadership at the Department of Justice (DOJ) and HHS, prosecutors and other attorneys say they have a pretty good feel for what health fraud enforcement will look like in 2021. The new kid on the block will be COVID-19 fraud and abuse, where it joins other recent priorities, including cases involving opioids and electronic health records (EHRs). DOJ and/or the HHS Office of Inspector General (OIG) also are expected to hammer away at kickbacks and substandard care in nursing facilities...

  6. The Impact of COVID-19 on Modern Slavery in Supply Chains Across the World

    2021 Asia Regional Compliance & Ethics Conference  | Presenter(s): Matthew Friedman  | January 2021 

    • COVID-19 is creating a situation where modern slavery within supply chains is increasing

    • This outcome is increasing the potential for significant business risk

    • There are a series of remedies that can be used to protect a business

  7. OIG and Other Important Updates: What We Learned in 2020

    2021 HCCA Web Conference  | Presenter(s): Margaret Hambleton, Bill Musick  | January 2021 

    • Discuss significant new and ongoing projects addressed in 2020 by the OIG, DOJ and other federal agencies that impact Hospital, Physician, Home Health and Hospice services

    • Provide practical advice on methods for compliance programs to effectively assess and address risks and guidance from the OIG and other Federal agencies

    • Describe the HHS Office of Inspector General’s (OIG) and means for tracking new developments

  8. CMS Update (2021 COVID-19 Essentials for Healthcare Compliance Programs)

    2021 COVID-19 Essentials for Healthcare Compliance Programs  | Presenter(s): Jean Moody-Williams  | January 2021 

    • Patients Over Paperwork Initiative

    • COVID-related changes and news

    • What to expect next from CMS

  9. Remote Workforce: Conducting Compliance Investigations (2021 COVID-19 Essentials for Healthcare Compliance Programs)

    2021 COVID-19 Essentials for Healthcare Compliance Programs  | Presenter(s): Gerry Zack  | January 2021 

    • Identify and overcome obstacles in conducting investigations remotely

    • Understand methods useful for remote analysis of records

    • Develop effective methods for conducting remote interviews

  10. Update on Recent OIG Activities

    2021 COVID-19 Essentials for Healthcare Compliance Programs  | Presenter(s): Christian J. Schrank, Amy Kearbey  | January 2021 

    • COVID-related work

    • Notable other actions

    • What compliance teams need to know for the coming months

  11. The Road Ahead: Effectively Managing Compliance Through the Next Stage of the Pandemic

    2021 COVID-19 Essentials for Healthcare Compliance Programs  | Presenter(s): Jenny O’Brien, Brett Short, Samantha Kelen, Kelly Willenberg  | January 2021 

    • Planning your trip: Developing workplans in an unfamiliar, remote, and quickly changing regulatory and work environment

    • Changing landscapes: Strategies to do more with less as your teams adjust to the next phase of the journey, including potentially returning to the office

    • Warning signs: Methods to identify compliance risk areas that may have been impacted the pandemic

  12. Health Care Cybersecurity Checklist for 2021

    Report on Patient Privacy Volume 21, Number 1. January 07, 2021  | Author: Jane Anderson  | January 07, 2021 

    Experts interviewed by RPP recommended a variety of strategies to stay ahead of evolving security threats this year, particularly as the COVID-19 pandemic winds down and threats from highly capable bad actors ramp up...

  13. Security Threats Soar From Nation-State Bad Actors as the New Year Gets Underway

    Report on Patient Privacy Volume 21, Number 1. January 07, 2021  | Author: Jane Anderson  | January 07, 2021 

    Security threats to health care entities will continue to escalate in 2021, as bad actors with significant capabilities target pandemic-weary organizations still struggling with a stay-at-home workforce, cybersecurity experts report...

  14. On the Eve of a New Administration, OCR Offers 'Comprehensive Reforms' to HIPAA

    Report on Patient Privacy Volume 21, Number 1. January 07, 2021  | Author: Theresa Defino  | January 07, 2021 

    With barely a month left before the Biden administration is set to take over, the HHS Office for Civil Rights (OCR) announced a proposed regulation that would dispense with the requirement for providers to obtain acknowledgement from patients that they have received a notice of privacy practices (NPP).[1]...

  15. HHS guidelines address racial disparities in COVID-19 testing and treatment

    Compliance Today - January 2021  | Authors: Jeremy P. Burnette, Sidney S. Welch  | January 2021 

    The year 2020 will certainly be remembered for at least two events: the COVID-19 pandemic and the far-reaching and sustained movement against racial inequality in America. These two events metaphorically intersect in guidance from the U.S. Department of Health & Human Services (HHS) Office for Civil Rights (OCR) designed to help providers ensure that their COVID-19 testing and treatment services do not discriminate on the basis of race, color, or national origin...

  16. Emerging ERM lessons from COVID-19: Considerations for compliance officers and managers of risk

    Compliance Today - January 2021  | Authors: Jeffrey Driver, Sarah Couture  | January 2021 

    For months, our world, our country, our healthcare systems, and our lives have been drastically altered by the COVID-19 pandemic. It has been impossible to hide from the realities of the pandemic as news, social media, and conversations with friends and colleagues have frequently centered on the continuously developing COVID-19 stories. At the same time, our healthcare systems have not been able to hide or be sheltered from the course-altering effects of the pandemic. Healthcare providers around the country have been rocked in multiple ways, including their financial health, their ability to take care of patients, and the new normal...

  17. Returning to business travel: Mitigating risk for your employees

    CEP Magazine - January 2021  | Author: Michael F. Savicki  | January 2021 

    The disruption of recent months has forced companies around the world to rewrite business plans and alter operations. Perhaps most significant has been the unprecedented migration of workers to virtual, work-from-home environments, necessitated by travel restrictions and the widespread lockdown of citizens. But as the rules curtailing people’s movement are eased, much has been written and said about the best way to get people back to their offices...

  18. Engage with your marketing team to avoid influencer marketing risks

    CEP Magazine - January 2021  | Author: Caroline Franco  | January 2021 

    With the increasing threats of banner blindness and ad blockers, influencer marketing has been constantly on the rise and has established itself across all industries. This marketing technique enables companies to collaborate with individuals with specialized knowledge, expertise, authority, and/or reach on social media by leveraging their unique voice and message-delivery styles. These individuals—called influencers—insert brands or products in their social media posts to initiate electronic word-of-mouth engagement with a tuned-in audience—their followers...

  19. Healthcare compliance investigations during a global pandemic

    Compliance Today - January 2021  | Authors: Alyssa Lawrence, Hannah Kent  | January 2021 

    Alyssa S. Lawrence (alyssa.lawrence@miami.edu) is Senior Director, Compliance, and Hannah G. Kent (hannah.kent@miami.edu) is Compliance Specialist at University of Miami Health System in Miami, FL...

  20. New year, new address for SCCE

    CEP Magazine - January 2021  | Author: Gerry Zack  | January 2021 

    Think of this month’s letter as part two of the letter I started last month. As we begin 2021, many of us are optimistic that better days lie ahead. When the COVID-19 pandemic became a serious threat last March, we did what many organizations did; we made a lot of quick decisions to protect our employees and our members, resulting in a remote workforce, the cancellation of in-person conferences, and gradual conversion to or development of virtual events. I discussed many of these changes last month...

  21. New year, new address for HCCA

    Compliance Today - January 2021  | Author: Gerry Zack  | January 2021 

    Think of this month’s letter as part two of the letter I started last month. As we begin 2021, many of us are optimistic that better days lie ahead. When the COVID-19 pandemic became a serious threat last March, we did what many organizations did; we made a lot of quick decisions to protect our employees and our members, resulting in a remote workforce, the cancellation of in-person conferences, and gradual conversion to or development of virtual events. I discussed many of these changes last month...

  22. Protecting corporate data in the work-from-home era

    CEP Magazine - January 2021  | Author: Melody Haase  | January 2021 

    Work restrictions created by COVID-19 forced companies worldwide to quickly adopt technologies and fundamentally change the way they do business. In October 2020, McKinsey & Company released the results of a survey that showed companies exponentially adopted digital technologies to do business, and these same companies do not expect that to change.[1] However, in a rush to adopt new technologies during a crisis, companies were often focused on business continuity rather than security...

  23. Compliance investigation and reporting in skilled nursing facilities

    Compliance Today - January 2021  | Author: April Bernabe  | January 2021 

    The nursing home industry is subject to numerous federal and state statutes, rules, and regulations, and skilled nursing facilities (SNFs) are required to investigate and report occurrences and events that meet defined criteria. Federal and state criminal and civil enforcement actions related to substandard quality of care can also lead to various governmental investigations. SNFs that have an established compliance and ethics program that includes robust investigation and reporting are in a better position of meeting fiduciary duties to provide quality care while navigating the challenges of evolving regulatory and enforcement actions...