Medicare Shared Savings Program ACO Final Rule Published

October 26th, 2011

The Department of Health and Human Services announced on October 20, 2011 that the anxiously-awaited Final Rule on Accountable Care Organizations has been published in the Federal Register. The final rule, “Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations“ has been changed substantially from the proposed rule, after over...

SHHH – Patients Are Healing

October 21st, 2011

We all know that a stay in a hospital is anything but quiet and restful. Monitors that beep continuously, rattling carts, TVs on in every room, ringing phones, squeaking wheels, and overhead pages all make it difficult to rest. Not only is all this noise annoying and unpleasant, but it...

Billing Company Possibly Responsible for HIPAA Data Breach

October 19th, 2011

As a follow up to my previous blog on whether hospital-based physicians need HIPAA programs (such as pathologists, anesthesiologists and radiologists), we are hearing about a major breach of medical records regarding a pathology billing company in the Boston area.
According to an article posted by, it appears the billing...

Steve Jobs's Legacy to Health Care

October 14th, 2011

Last week the world lost Steve Jobs, whose innovations in personal computing, music, telecommunications, and consumer electronics transformed the way we learn, play, and communicate with each other. The health care community has also been transformed by the iPad, iPhone, and iPod, along with health applications developed specifically for these...

Deadline to Apply for eRx Exemption is November 1, 2011

October 12th, 2011

 On October 6, 2011, the Centers for Medicare and Medicaid Services published the Final Rule for Electronic Prescribing (eRx), setting forth how eligible providers (or group practices) can use “significant hardship exemptions” to avoid Physician Fee Schedule penalties. If providers or practices do not apply for these exemptions by November...

Lighten Up on Salt – Guidelines?

October 7th, 2011

Recently the Salt Institute (a trade group for salt companies) has accused the federal government of bias and breaking federal law by disregarding scientific literature in its recommendations that Americans consume less sodium. In a 17-page letter sent to the Department of Agriculture and the Department of Health and Human...

Natural Disasters and Sharing PHI Under the HIPAA Rules

October 5th, 2011

It’s an unpleasant thought, but unfortunately, natural disasters are becoming a way of life. Every day, there are news reports of flooding and landslides, wildfires, tornadoes, hurricanes, severe storms---even earthquakes, volcanic eruptions and tsunamis. The list goes on and on, and healthcare providers are on the front lines when these...

Million Hearts

September 30th, 2011

Last week, the Department of Health and Human Services launched Million Hearts, a new initiative aimed at preventing one million heart attacks and strokes over the next five years. The initiative will focus on two goals: empowering Americans to make healthy choices, and improving care for people who need treatment.

50 Tips to Avoid Breaches of Protected Health Information

September 23rd, 2011

Last Friday’s blog reported on the Department of Health and Human Services’ report to Congress on 7.8 million reported breaches of protected health information (PHI) in 16 months.
Theft was the leading cause of breaches, followed closely by loss of data through negligence or human error. Thefts included the loss of...

Medicaid RAC Final Rule Issued by CMS

September 21st, 2011

A final Rule has been issued by the Centers for Medicare & Medicaid Services (CMS), to assist in guiding State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. It directs States to assure that adequate appeal...

Breaches of Protected Health Information Tops 7.8 Million

September 16th, 2011

A recent report issued to Congress by the Department of Health and Human Services (HHS) revealed some staggering figures: from September 23, 2009 through December 31, 2010 (less than 16 months) the protected health information (PHI) of 7.8 million individuals was compromised.
The 2009 Breach Notification for Unsecured Protected Health Information...

Do Hospital-Based Physician Groups Need an OHCA to Comply With HIPAA?

September 14th, 2011

 For most physician groups, the fact that they need to establish HIPAA/HITECH programs for their organizations is an unquestioned fact of life, but there are other types of physician groups who may legitimately wonder if they must do this.
For instance, do physicians affiliated with a hospital, and working exclusively at...

Is It Wise to Remove Wisdom Teeth?

September 9th, 2011

By high school graduation, the baby teeth are long gone, the orthodontic braces have been removed, and a broad, beautiful smile showcasing healthy, straight teeth peers out from the senior yearbook. The trials of adolescent dentistry appear to be over, but lurking beneath the gums is the next dental challenge:...

Data Security Lapse Affects 300,000 California Workers' Compensation Claims

September 7th, 2011

Another large data security breach involving 300,000 people in California recently occurred through an independent researcher, adding even more individuals to the growing number of people affected nationwide by medical information security lapses.
In a report by the Associated Press, the researcher, Aaron Titus from the data security firm Identity Finder,...

Avoiding Exposure to Chemotherapy Drugs for Health Care Workers

September 2nd, 2011

Health care workers who administer antineoplastic drugs (chemotherapeutic agents that control or kill cancer cells) at are risk for unintentional chemotherapy exposure. All workers who handle these drugs, including nursing personnel, veterinary care workers, pharmacists, and even shipping and receiving personnel are at risk.
Workplace exposures to hazardous drugs can cause...

Medicare Revalidation Requests Coming, Will Reduce Fraud and Abuse

August 31st, 2011

 Many aspects of the ACA have been geared towards reducing fraud in federal payer programs. One recent initiative will have a direct affect on providers going forward, and that is the requirement that Medicare- enrolled providers and suppliers must revalidate their enrollment information with the Centers for Medicare and Medicaid...

Is Your Dial Soap and Colgate Toothpaste Safe?

August 26th, 2011

Triclosan – not exactly a word you hear every day, but it is so prevalent in our lives that the Centers for Disease Control and Prevention found it present in the urine of 75 percent of Americans over the age of five. Triclosan is the active ingredient added to a...

Get Prepared, HIPAA/HITECH Audits are Coming

August 25th, 2011

According to, the Department of Health and Human Services has awarded a HIPAA auditing contract to the firm KPMG, who will be responsible for assisting the Office of Civil Rights (OCR) with HIPAA audits. The audits are required under HITECH, and will be geared towards both covered entities and...

Is PPE SOP for OPIM? An EZ Guide to Healthcare Acronyms

August 19th, 2011

OSHA wants CEs to have an HCP as well as ECPs to protect against BBP, HIV, HBV, and OPIM. PPE can help, especially with MRSA. HIPAA and HITECH protect PHI and EPHI, and all patients should read your NPP. Otherwise the OCR and DOJ won’t be happy. OMG! We live...

HIPAA / HITECH Enforcement Allows Fines and Jail for Employees

August 17th, 2011

 As part of the HITECH Act (Health Information Technology for Clinical and Economic Health Act), the individual State Attorney Generals (SAGs) were given the authority, on behalf of state residents, to bring civil actions against individuals who violate the HIPAA laws. Up until HITECH became law, only covered entities, and...

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