In the wake of several large breaches, OCR is ready to ramp up its oversight of HIPAA compliance as it embarks upon Phase 2 of its HIPAA privacy, security, and breach notification audits. OCR began preparing for this round of audits around the same time that news broke of the second-largest HIPAA breach in the U.S., a hacking incident that affected 4.5 million patients treated at or referred to Tennessee-based Community Health Systems, Inc.
If the 2-midnight rule keeps you up at night, it might help to add some PEPPER to your processes. CMS recently updated PEPPER, otherwise known as the Program for Evaluating Payment Patterns Electronic Report, to provide hospitals with insight into how well they're doing with 2-midnight rule compliance.
CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due to a miscalculated copayment for stereotactic radiosurgery, according to the October update to the OPPS and Integrated Outpatient Code Editor (I/OCE).
To fully understand where your organization's risks lie, you not only need to have a firm grasp on risk analysis and assessment processes, you need to define these processes as well.
