Having performed discharge planning for many, many years, I’ve learned one key component is now more true than ever: Assessments must be very comprehensive. We are dealing with a wider variety and different mix of patients. For example, we are seeing an older population that is living longer, often with dementia. These are patients with multiple comorbidities who are living on a limited income. We also are dealing with a larger group of patients—again, with multiple comorbidities—who are living longer due to medical advances and require costly medications and repeated readmissions for complications or procedures. Additionally, we care for the homeless, who are often riddled with mental health or drug addiction problems as well as comorbidities.
Q: OCR has said that the comprehensive HIPAA audits will occur in 2017. We received a pre-audit letter as a CE but were not audited as part of the CE round of phase two desk audits. What is included in the comprehensive audits, and is there a chance we will be audited?
This week’s Medicare updates include additional guidance on the MOON form, an NCA for leadless pacemakers, delayed implementation of the (ESRD) Interim Final Rule – Third Party Payment, and more!
The 2017 OIG Work Plan is out, and there are a few areas that may affect case management, particularly with regard to the 2-midnight rule, skilled nursing facilities, ambulance services, and home health agencies. Regardless of the changes in each year’s Work Plan, the document as a whole should remind case managers that they need to comply with the rules.
An insurer agreed to a multimillion dollar HIPAA settlement in the Office for Civil Rights’ (OCR) second HIPAA settlement of the year. The agency looks to be on track to continue last year’s trend of increased activity and high-profile multimillion dollar settlements.
Q: We started providing allogenic hematopoietic stem cell transplants on an outpatient basis for some of our patients. Until just recently, none of them were Medicare patients, but now we have some patients that meet the physician-established criteria for the transplant being done as an outpatient. How do we include this on the claim to ensure that the cost of all components of this service are reported?
This week’s Medicare updates include the latest Medicare Quarterly Provider Compliance Newsletter, a proposed decision memorandum for hyperbaric oxygen therapy NCA, new interest rates for Medicare overpayments and underpayments for Q2 2017, and more!
An Illinois healthcare network is the first organization hit with a HIPAA settlement fine for violating the timely breach notification requirement, the Office for Civil Rights (OCR) announced January 9.
Q. Are we required to report cybersecurity incidents to federal agencies other than the Office for Civil Rights, such as the Department of Homeland Security?
