COVID-19 Resources

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  1. How to mentor the next generation of compliance officers-millennials?

    Compliance Today - August 2020  | Author: Catherine Boerner  | Published: August 2020 

    As you know, “millennials” is the name given to the generation following Generation X—those born between 1981 and 1996. The whole idea of naming generations and identifying differences based on how they were raised and educated as children can shed some light on how, as adults, they work in the workforce. Yes, this can be viewed as stereotyping, but there might be nuggets of truth that might make all the generations get along...

  2. Virtual monitoring

    Compliance Today - August 2020  | Author: John Falcetano  | Published: August 2020 

    As we have recently seen, pandemics can affect the way clinicians have to treat their patients. In an effort to reduce exposing vulnerable populations to COVID-19, physicians turned to technology and started using telehealth to remotely treat their patients more often, thereby reducing the chance of contracting the deadly virus. The pandemic also caused compliance professionals to rethink how they were monitoring for compliance. Many compliance professionals found themselves working remotely along with other staff to carry out their compliance functions. Compliance professionals had to evaluate compliance processes, such as monitoring activities, and find new ways to complete tasks...

  3. Blockchain: Moving target or trusted tech trend? 

    CEP Magazine - August 2020  | Authors: Susan Dworak, Teri Quimby  | Published: August 2020 

    Government often finds itself in the uncomfortable situation of applying old regulations to new ideas; it’s a regulator’s worst nightmare. Legal and regulatory umbrellas need to be flexible enough to expand with the passage of time, yet definitive enough to endure history in the making. For example, a decade ago the ideas of social media and apps were different than today. The idea of ordering a cup of coffee using an app, paying for it, and picking the product off the counter with your name on it—without talking to a single human being—seemed unimaginable. Enter disruptive blockchain-based solutions, which may...

  4. So Many Lab Codes, So Many Dates: Keeping Up With COVID-19

    Report on Medicare Compliance Volume 29, Number 27. July 27, 2020  | Author: Nina Youngstrom  | Published: July 27, 2020 

    CMS added new codes in its July 2020 update of the Hospital Outpatient Prospective Payment System (OPPS), according to an updated revised MLN Matters (MM11814 Revised).[1]...

  5. COVID-19 Adds Twist to Sequencing for DRGs; Lab Coding Is Risk With Many Effective Dates

    Report on Medicare Compliance Volume 29, Number 27. July 27, 2020  | Author: Nina Youngstrom  | Published: July 27, 2020 

    It’s the pandemic version of which came first, the chicken or the egg: A patient with COVID-19 is admitted to the hospital for a heart attack, and the sequencing of the principal and secondary diagnoses may be unclear. If the patient is diagnosed with COVID-19 because of a positive test, should that be sequenced first and the myocardial infarction second or the other way around? Either way, hospitals will get the 20% bump for the MS-DRG because a COVID-19 diagnosis will be on the claim. But whether it’s principal or secondary affects the MS-DRG assignment and therefore the reimbursement...

  6. Home Health Audit Demonstration Is Back; HHAs Have Three Choices

    Report on Medicare Compliance Volume 29, Number 27. July 27, 2020  | Author: Nina Youngstrom  | Published: July 27, 2020 

    CMS is resuming its home health pre-claim review demonstration, which is designed to identify and prevent overpayments, on Aug. 3. The five-year Review Choice Demonstration for Home Health Services,[1] as it’s formally known, gives home health agencies (HHAs) in five states three options for medical reviews...

  7. Court Restores Site-Neutral Payments; Lawyer: More Trouble May Be Ahead

    Report on Medicare Compliance Volume 29, Number 27. July 27, 2020  | Author: Nina Youngstrom  | Published: July 27, 2020 

    In a blow to hospitals, the U.S. Court of Appeals for the District of Columbia Circuit ruled July 17 that CMS was within its rights to cut outpatient hospital payments under its site-neutral payment policy.[1] In overturning a 2019 federal district court decision, the appeals court agreed that CMS has statutory authority to use methods to control unnecessary increases in outpatient services...

  8. News Briefs: July 27, 2020

    Report on Medicare Compliance Volume 29, Number 27. July 27, 2020  | Author: Nina Youngstrom  | Published: July 27, 2020 

    ◆ Metropolitan Community Health Services in North Carolina, doing business as Agape Health Services, has agreed to pay $25,000 to settle potential violations of the HIPAA Security Rule, the HHS Office for Civil Rights (OCR) said July 23.[1] Metro, a federally qualified health center, serves an underserved population in rural North Carolina, which OCR considered in reaching the settlement. It stemmed from a June 9, 2011, breach report filed by Metro about the impermissible disclosure of protected health information to an unknown email account, affecting 1,263 patients. “OCR’s investigation revealed longstanding, systemic noncompliance with the HIPAA Security Rule. Specifically, Metro failed...

  9. Don't Leave Enforcement of Research Restart Rules to PIs, JASON Advises in COVID-19 Report

    Report on Research Compliance Volume 17, Number 8. July 23, 2020  | Author: Theresa Defino  | Published: July 23, 2020 

    In an extensive new report on how universities can safely restart research in light of the still-unfolding COVID-19 pandemic, JASON, an independent science advisory group, recommended that surgical mask use, daily symptom monitoring and physical spacing are essential.[1] But the group, which most recently weighed in on strategies to combat foreign influences in U.S. research,[2] has a warning about how to make sure the new “rules” and best-laid plans are followed—and it’s one that just might gladden the heart of research compliance officials. (It also could make a little extra work for them, however)...

  10. Product pivoting: Compliance issues to consider

    Report on Supply Chain Compliance Volume 3, Number 14. July 23, 2020  | Author: Karen Kroll  | Published: July 23, 2020 

    Over the past few months, numerous companies have shifted from their regular lines of business. Instead of, for instance, making running shoes[1] or producing artisan liquor,[2] they’re crafting face masks or formulating hand sanitizer...

  11. Amazon workers in Germany go on strike

    Report on Supply Chain Compliance Volume 3, Number 14. July 23, 2020  | Author: Sascha Matuszak  | Published: July 23, 2020 

    Amazon has come under fire[1] during the pandemic for allegedly disregarding the safety of its workers and for silencing and firing workers who speak out about worker conditions...

  12. RRC E-Alerts: July 9, 2020

    Report on Research Compliance Volume 17, Number 8. July 23, 2020  | Author: Theresa Defino  | Published: July 23, 2020 

  13. In This Month's E-News: August 2020

    Report on Research Compliance Volume 17, Number 8. July 23, 2020  | Author: Theresa Defino  | Published: July 23, 2020 

    ◆ Higher education groups and others are hailing a decision by the administration to rescind planned rules that would have required students in the United States on certain visas to attend class in person or return home. The reversal came during a hearing before a judge in Boston presiding over a challenge to the rules filed by more than a dozen states and spearheaded by Massachusetts Attorney General Maura Healey. Harvard University and the Massachusetts Institute of Technology had also filed suit after Immigration and Customs Enforcement announced on July 6 it planned to publish a temporary final rule stating...

  14. OIG: Hospitals Overbilled $1B for Malnutrition, CMS Will Recoup; Other Audits to Resume

    Report on Medicare Compliance Volume 29, Number 26. July 20, 2020  | Author: Nina Youngstrom  | Published: July 20, 2020 

    Hospitals should brace themselves for possibly returning money related to severe malnutrition, perhaps going back six years, now that the HHS Office of Inspector General (OIG) estimates they overbilled Medicare $1 billion by incorrectly assigning two diagnosis codes on inpatient claims. CMS and hospitals will split the job of repaying Medicare, with CMS recouping money from the reopening period and instructing providers to follow suit under Medicare’s 60-day refund rule, according to OIG’s report.[1] For hospitals that already had a medical review of malnutrition through Targeted Probe and Educate (TPE), another round of recoupment is a setback, one compliance officer...

  15. HHS Finalizes Part 2 Rule; More Changes Are Coming from CARES Act

    Report on Medicare Compliance Volume 29, Number 26. July 20, 2020  | Author: Nina Youngstrom  | Published: July 20, 2020 

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

  16. OIG to Audit Advance Care Planning, Which Has No Billing Cap

    Report on Medicare Compliance Volume 29, Number 26. July 20, 2020  | Author: Nina Youngstrom  | Published: July 20, 2020 

    In a reminder that regular audits continue amid the scourge of the COVID-19 public health emergency (PHE), the HHS Office of Inspector General (OIG) has added advance care planning (ACP) to its Work Plan.[1] Because this is a national audit, billing patterns for the two CPT codes of ACP apparently set off alarm bells loud enough to wind up on the Work Plan, which tends to be jam-packed right now with items related to the PHE...

  17. Snapshots of COVID-19's Impact on Compliance Programs

    Report on Medicare Compliance Volume 29, Number 25. July 13, 2020  | Author: Nina Youngstrom  | Published: July 13, 2020 

    Here are some of the results of a June survey, “Compliance and the COVID-19 Pandemic,”[1] which was conducted by the Society of Corporate Compliance and Ethics & Health Care Compliance Association (SCCE & HCCA). Results are based on 343 responses from compliance and ethics professionals in the SCCE & HCCA database. They were analyzed using SurveyGizmo, a third-party system that’s web based...

  18. News Briefs: July 13, 2020

    Report on Medicare Compliance Volume 29, Number 25. July 13, 2020  | Author: Nina Youngstrom  | Published: July 13, 2020 

    ◆ Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers for multi-dosing patients from single-use vials of ranibizumab and Eylea, the U.S. Attorney’s Office for the Middle District of Florida said June 30.[1] The practice didn’t admit liability in the settlement...

  19. With Telehealth on OIG Work Plan, Beware Pitfalls; CMS Proposes HHA Telehealth Past PHE

    Report on Medicare Compliance Volume 29, Number 25. July 13, 2020  | Author: Nina Youngstrom  | Published: July 13, 2020 

    When a physician’s telehealth visit with a Medicare patient on FaceTime cut out after five minutes, they shifted to an audio-only visit, with the physician and patient speaking on the telephone. Although the call lasted for an hour, the physician didn’t document the time. That put her in a bind. To bill a time-based evaluation and management (E/M) service, such as a phone call, providers have to document the total time. They can only use medical decision-making to support office visit codes when the audio and visual components are live for the majority of the encounter...

  20. Appeals Court Restores Big FCA Verdict; SNFs Hit With $255M in Whistleblower-Only Case

    Report on Medicare Compliance Volume 29, Number 25. July 13, 2020  | Author: Nina Youngstrom  | Published: July 13, 2020 

    A federal appeals court has reinstated a huge jury award in a False Claims Act (FCA) case against a Florida skilled nursing facility (SNF) management company that was pursued by a whistleblower after the Department of Justice (DOJ) declined to intervene...

  21. COVID-19 Pandemic Security Strategies, Checklist

    Report on Patient Privacy Volume 20, Number 7. July 09, 2020  | Author: Jane Anderson  | Published: July 09, 2020 

    Since the COVID-19 pandemic began, health care organizations have been overwhelmed, trying to manage telework, telehealth and ward off increasing threats to their protected health information.[1] But security professionals also are finding organizations are adapting and implementing strategies to safeguard protected health information. Still, there is always more they could do, and the experts recommend a variety of tactics to keep health care entities safe in the coming months, as the pandemic continues...

  22. OCR: Yes, You Can (Contact COVID-19 'Survivors' About Blood Donations)

    Report on Patient Privacy Volume 20, Number 7. July 09, 2020  | Author: Theresa Defino  | Published: July 09, 2020 

    Many a HIPAA covered entity (CE) pulls back from sharing information, even when permitted to do so, because of fear of enforcement action by the HHS Office for Civil Rights (OCR); many a family member is told “HIPAA won’t let me,” when asking for information they are allowed to have...

  23. Privacy Briefs: July 2020

    Report on Patient Privacy Volume 20, Number 7. July 09, 2020  | Author: Jane Anderson  | Published: July 09, 2020 

    ◆ Concerns about hacking and online security have fallen since the onset of the COVID-19 pandemic, despite the fact that the actual risks have risen, according to the 2020 Unisys Security Index report.[1] The World Health Organization (WHO) and Interpol have warned of increased cyberattack risk during the pandemic, and estimates indicate there have been as many as 192,000 coronavirus-related cyberattacks globally per week in May 2020 alone, a 30% increase compared to April. Google’s Gmail service reported that it saw more than 18 million daily malware and phishing emails related to COVID-19 scams in just one week, and more...

  24. Big Breaches, Down in First Half of 2020, Show Role of BAs; Increase May Be Coming

    Report on Patient Privacy Volume 20, Number 7. July 09, 2020  | Author: Theresa Defino  | Published: July 09, 2020 

    During the first six months of this year, 228 breaches affecting 500 or more individuals were reported to the HHS Office for Civil Rights (OCR), and of the top 20, five involved business associates (BAs), including the largest.[1]...

  25. COVID-19 emergency preparedness kit

    Compliance Today - July 2020  | Author: Catherine Boerner  | Published: July 2020 

    As compliance professionals, I am sure all of you have discussed with your families a COVID-19 emergency preparedness family plan. My husband and I did it early on. We discussed where someone would quarantine (our master bedroom) and what they would need. I ordered a finger pulse oximeter, blood pressure wrist cuff, extra thermometers, and extra batteries. We didn’t buy extra toilet paper, but we bought extra bottled water, vitamin water, Gatorade, chicken noodle soup, and made a list of possible meals and filled the freezers with food...