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Foley's top 10 compliance risks for hospitals

Case Management Weekly, December 4, 2007

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The Health Care Industry Team of national law firm, Foley & Lardner LLP, announced its "Top 10" compliance risks for hospitals and health systems in 2008 in an effort to identify key compliance risks for its clients. Although every facility faces its own unique set of challenges, Foley predicts the major compliance challenges for the upcoming year. Highlights of the list include:

Number 10: Medicaid - Deficit Reduction Act (DRA) and False Claims Act
Changes under the DRA of 2006 include rewards and penalties for states relative to their Medicaid enforcement programs, and promises increased attention to compliance and fraud issues under Medicaid programs.

Number 5: Medicare Severity Diagnosis Related Groups
Medicare is initiating a profound change in the grouping of diagnoses under the inpatient prospective payment system. New rules, and opportunities for significantly decreased reimbursement, require immediate vigilance in the hospital community.

Number 4: Present on Admission and Hospital Acquired Conditions
These new rules will result in payment denials unless accurate coding is performed on patients' intake and admission.

Number 1: Quality
The number one challenge facing hospitals in 2008 will be delivering quality care due to payment and compliance challenges.

To read the full "Top Ten," click here

Source: Mondaq

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