Ready or not, Phase 2 of OCR's HIPAA audit program is nearly ready to begin, and healthcare organizations and their business associates (BA) should be prepared to open their books to federal regulators.
There are a number of tools on the market to assist covered entities (CE) and business associates (BA) in addressing their compliance needs. Solutions range from large governance, risk, and compliance programs to tools that assist in the development of a compliance program. When it comes to ongoing compliance management, Ostendio's My Virtual Compliance Manager™ (MyVCM™) offers a solution that is more than just a tool for an occasional look at the compliance stance of an organization.
HIPAA originally recognized the business associate (BA) as a contractor of a covered entity (CE), but did not mandate direct accountability to the regulations. This put the onus on a CE to ensure, contractually, that its BAs met applicable requirements and supported their CE clients' compliance. When the Privacy and Security Rules first became effective, many CEs accepted BA contracts (BAC) (sometimes also called BA agreements [BAA]) from their BAs. Some BAs were actually quite adamant about having the CE sign their BAC. Although it was the obligation of a CE to initiated the BAC and the CE was liable under the law for compliance, in most cases, BAs offered a BAC that met the legal requirements and often looked like the model offered by HHS. If this was not the case or if either party wanted additional provisions, the CE and the BA negotiated a contract. No provisions required by HIPAA could be removed or changed, but other provisions could be added.
Q: Is it permissible to write down a patient's pending exams (e.g., MRI, ultrasound) on the patient boards located by the patient's bed in his or her room even if that patient has a roommate?
The 2-midnight rule may get a little tweak if the proposals in CMS' 2016 OPPS proposed rule comes to fruition. The rule proposes that physicians now be granted a little more flexibility when it comes to ordering inpatient admissions, even when the stay is expected to be less than two midnights?provided of course that the stay is justifiable from a medical standpoint and the physician clearly documents his or her thinking on the case.
The 2016 OPPS proposed rule released July 2 is deceptively short, but packs a punch. CMS is proposing the most massive APC reconfiguration and consolidation of APC groups since the beginning of OPPS, says Jugna Shah, MPH, president and founder of Nimitt Consulting, based in Washington, D.C., and Spicer, Minnesota.
To get a real sense of the financial impact, providers will need to take several steps, says Shah. First, review the narrative text to get a feel for the major categories of changes CMS is proposing, including some of the operational ones.
