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News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance will be your guide for avoiding fraud and maintaining compliance.

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Strategies for Health Care Compliance

Issue 12, December 1, 2008 - VIEW THE FULL ISSUE

• Examine short stays, avoid overpayment

  When the recovery audit contractor (RAC) demonstration project ended March 27, the evaluation...

• Direct-to-consumer genetic testing is a state matter

  California began cracking down on direct-to-consumer genetic testing companies in June. The...

• Hectic ERs present audit challenges, compliance risks

  The emergency room (ER) is among the most frantic and fast-paced areas in the hospital. Doctors and...

• Is your facility prepared for disaster?

  Disasters are not exclusive to any one area. Some areas may be more susceptible to tornados...

• Imaging accreditation will be mandatory in 2012

  Your imaging facility is on the clock. The Medicare Improvements for Patients and Providers Act of...

Issue 11, November 1, 2008 - VIEW THE FULL ISSUE

• Ensure coders submit compliant claims

  Physician documentation plays a big part of the billing process in medical facilities. But no...

• 'No comment': How to keep the press at bay

  It doesn’t matter whether your facility is located in a large metropolis or a small town. The...

• Improve compliance with a clinical documentation program

  How can coders ensure that they assign the correct present-on-admission (POA) indicator? How can...

• Make sure your board of directors knows its role

  Corporate directors shoulder more responsibility for their organization’s regulatory...

• ICD-10 is coming: Educate physicians and IT, not just coders

  ICD-10 is no longer that monster over the horizon, under the bed, or in the closet. Years of...

Issue 10, October 1, 2008 - VIEW THE FULL ISSUE

Issue 9, September 1, 2008 - VIEW THE FULL ISSUE

• Patient status: Five tools to conduct internal audits

  In an era of greater accountability and enforcement, hospitals and treating physicians will be...

• New York's work plan serves as an audit cheat sheet

  The detailed work plan released April 22 by New York's Office of the Medicaid Inspector General...

• HIPAA and the modern blended, extended family

  Protecting patient information has always been challenging. But these days, it's downright...

• Train your staff with a compliance carnival

  Although a carnival or fair requires substantial planning, such an event can be a great way to...

• Five tips to ensure laboratory medical necessity compliance

  To ensure that laboratory tests are medically necessary, your facility must do more than just abide...

• Coder vs. biller: Does this match have a referee?

  The friction between billing and coding departments is a subject often discussed among HIM...

Issue 8, August 1, 2008 - VIEW THE FULL ISSUE

• Know your hospital's rights

  Patients' right to privacy protection or to have access to a caregiver of their choice are the most...

• Workers' compensation: Understand rules for disclosures

  Although HIPAA details the handling of personal health information (PHI) that stems from workers...

• Help nurses and clinical staff comprehend compliance

  Editor's note: Use this sample quiz from HCPro's Online Learning Library, "Understanding Your Role...

• Tips for compliant long-term care of short-stay patients

  Short-stay outliers for long-term care hospitals (LTCH) steadily declined between fiscal years (FY...

• New ABN form means more options and more questions

  Editor's note: The new advance beneficiary notice (ABN) has three options for patients: obtaining...

Issue 7, July 1, 2008 - VIEW THE FULL ISSUE

• Get ready to audit POA

  CMS completed its phased implementation of the present-on-admission (POA) reporting requirements...

• Tools to teach physicians about HIPAA compliance

  Training physicians about HIPAA compliance is difficult. Physicians can be independent and...

• HIPAA quick quiz for physicians

  Editor's note: Use this sample quiz to train your physicians on what they need to know about HIPAA...

• Use internal audits to find Medicaid problems

  Today, you need to worry about more than Medicare billing errors. Medicaid investigations are on...

• MQSA cites facility for lapse in timely scan-result reporting

  Mammography Quality Standards Act (MQSA) inspectors appear to be making good on the FDA's promise...

Issue 6, June 1, 2008 - VIEW THE FULL ISSUE

• CAD use questioned

  CAD use is being questioned by those who use the equipment as a second pair of eyes, says John...

• Don't let your staff members' HIPAA awareness lapse

  If you have settled into a compliance routine, be careful not to get into a rut: Your staff members...

• Protect health information across department silos

  It's probably scribbled on Post-it notes, jotted on notebook paper, saved on computer desktops or...

• Adopt a physician scorecard to assess compliance

  Regular auditing and analysis of physicians' evaluation and management (E/M) coding and...

Issue 5, May 1, 2008 - VIEW THE FULL ISSUE

• Five steps to improve HIPAA security audits

  If you are not on CMS' list of potential PricewaterhouseCoopers HIPAA audits, be thankful. But take...

• Radiology bears brunt of Stark II, Phase III implications

  Make sure your radiology group is up to speed about Stark changes. The Stark II, Phase III final...

• Control gift giving to prevent legal trouble

  Lavish catered lunches. Premium tickets to sporting events. All-expenses-paid trips to conferences...

• Compliance tools to help handle DWI draws in the lab

  Drawing blood for purposes of prosecuting those driving while intoxicated (DWI) could obligate your...

Issue 4, April 1, 2008 - VIEW THE FULL ISSUE

• Consider all elements of HIPAA agreement life cycle

  There was probably a time a few years ago when you asked your staff members to provide copies of...

• Compliance essentials for radiology departments/facilities

  Take the top concerns of three radiology administration professionals to heart as they outline...

• Watch ESRD payments, implement control strategies

  An OIG audit recently resulted in a hospital repaying more than $60,000 for laboratory services to...

• Take your board of director discussions to the next level

  You may have noticed increased attention from the board of directors and compliance board recently...

Issue 3, March 1, 2008 - VIEW THE FULL ISSUE

• Be prepared for coming recovery audit contractors

  One rehabilitation hospital in California offers a glimpse of what might be your future: It has two...

• Take time to examine physical therapy community

  During the past few years, CMS peppered the physical therapy community with transmittals designed...

Issue 2, February 1, 2008 - VIEW THE FULL ISSUE

• OIG/AHLA team up to address lab quality

  Healthcare administrators and compliance officers have new guidance to help them comply with...

• Protect data, even data at rest

  State laws requiring notification of a security breach to patients whose protected health...

• Documentation key to POA compliance

  Medicare doesn't want to pay hospitals to treat problems patients developed due to their stay at a...

• Tips to deal with media blitz in crisis cases

  They are the kind of headlines that can make hospital officials cringe. "Thousands of patients...

Issue 1, January 1, 2008 - VIEW THE FULL ISSUE

• Oregon creates NPI and provider authentication data repository

  Healthcare organizations in Oregon have found their own approach to remedy the quality...

• Be aware of minors' privacy rights regarding HIPAA

  When divulging protected health information (PHI) to patients' family members, it is well known...

• Make smart use of new OIG Work Plan in 2008

  The OIG posted its 92-page plan on October 1, 2007, detailing what areas the OIG expects to audit...

• Updated sepsis, pain management coding

  Although there are not any surprising changes to the new ICD-9-CM coding guidelines, they do...