HCPro.com: Health Care Auditing Strategies

June 2008 (Volume 7, Issue 6)	view entire issue

EMTALA provides ongoing challenges, opportunities
CMS released the newest revisions to the Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA) in March, which included new requirements for on-call physicians and new guidance for disaster protocol development. That's good news, says Nickie Braxton, compliance officer at Hartford (CT) Hospital and Hartford Healthcare Corp., because it further delineates existing EMTALA rules and gives you more guidance on how to comply with the act.

Three-pronged approach appropriate for quality concerns
At the Health Care Compliance Association's (HCCA) Compliance Institute in May, quality of care presentations covered issues such as correct use of data, board education, and government enforcement. The presenters' message was clear: Quality is quickly becoming an integral component of reimbursement, and it needs to be incorporated into your existing compliance programs.

Examine FMV for physicians in administrative roles
Placing physicians in paid positions for administrative roles requires great care because failure to set compensation at fair market value (FMV) could result in criminal or civil penalties based on healthcare fraud and abuse laws. If an agreement between a physician and healthcare organization is audited by federal or state healthcare authorities, the analytical process and documentation to justify the payment of FMV will be essential in defending the physician's compensation level.

Patients' Bill of Rights: How and when to abide by it
When a medical facility runs into trouble regarding the Patients' Bill of Rights, more than likely it is the patient's rights that are at issue, whether it be a question of privacy protection or access to a caregiver of the patient's choice. Less common are scenarios when a patient tries to wield the bill of rights in a way that infringes on the rights of the medical facility and its caregivers.

Other recently-published articles from Health Care Auditing Strategies:

HCAS 2008 index

Step up HIPAA compliance through auditing measures

Create a compliant on-call payment model

Ease your compliance worries: Get ready for 2009

Three-day rule: Know the details to stay in compliance

Lucrative cath labs raise red flags

New CMS rules for ABNs require auditing

Scrutiny of medical errors increases

Conquer EMTALA on-call provision challenges

Three HACs added in IPPS rule

Proceed to EHR with caution, planning

RAC guinea pigs give glimpse of what’s to come

Work Plan focuses on quality

Take a long-term approach to short-stay audits

Encoder software may lead to clinically inaccurate coding

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