Today’s HIM professional needs to understand the various programs and the impact that coding and documentation may have on an organization’s performance. By 2018, 50% of Medicare payments will be tied to value-based alternative payment models.
Most healthcare systems already have a proven process in place to monitor revenue integrity and ensure correct reimbursement. Beyond the day-to-day revenue cycle staff involved in revenue integrity, more than 60% of hospital executives believe revenue integrity is essential to their organization’s financial stability and sustainability, according to a survey by Craneware, Inc.
Information security officers often have their hands full with HIPAA. But as high-deductible health plans have patients paying more out of pocket, it’s time organizations took a closer look at another set of cybersecurity guidance: the Payment Card Industry Data Security Standard (PCI DSS).
Almost a year after the world of coding was transformed by the implementation of ICD-10-CM/PCS, CMS released the 2017 ICD-10-CM Official Guidelines for Coding and Reporting along with more than 5,000 diagnosis and procedure code changes. The new codes and guidelines went into effect October 1, but not without some controversy. Many of the changes were praised for the increased clarity and level of detail they allow providers to capture. Other changes, though, raised questions and eyebrows and left some wondering what the Cooperating Parties may have intended.
It’s been a challenging year for HIPAA compliance. OCR levied more than $20 million in breach settlement fines. Ransomware rocked the healthcare industry.
A new phishing scam targeting covered entities (CE) and business associates (BA) is disguised as an official communication from the Office for Civil Rights (OCR). In an alert released November 28, OCR advised CEs and BAs that a phishing email is being circulated on fake HHS letterhead with the signature of Jocelyn Samuels, OCR’s director.
The University of Massachusetts Amherst (UMass) agreed to a $650,000 HIPAA settlement fine after a breach investigation revealed the university failed to implement basic security measures.
Single-use drug vial wastage and CMS’ implementation of the Quality Payment Program are in the spotlight in the Office of Inspector General’s (OIG) fiscal year 2017 Work Plan. The Work Plan, released November 10, outlines areas the OIG will scrutinize in the coming year and ongoing projects.
