Denial management in healthcare – sounds like a topic that Chief Financial Officers and Revenue Cycle Directors are very interested in. However, in today’s environment, where every bit of lost…
Changes in the OIG Self-Disclosure Protocol
Eight years after the last revision, the Office of Inspector General (OIG) of the Health and Human Services Department has updated the OIG Self-disclosure Protocol. The update was issued on…
HIPAA Physical Safeguards: Security Rule Implementation
HIPAA’s Security Rule requires that there be measures, policies, and procedures in place that address a covered entity or business associate’s efforts to secure electronic protected health information (ePHI). It…
Key Performance Indicators for Healthcare
There are a lot of people offering key performance indicators (KPIs) or healthcare metrics for the healthcare industry. If you are a physician or medical group, should you consider developing…
HIPAA Wall of Shame: no hiding from the public facts
The HIPAA Wall of Shame is a highly visible reminder that data breaches involving protected health information are real, and can have serious consequences for all involved. You can learn…
Medical Practice Valuation: What factors matter most?
A medical practice valuation (especially from a consultant!) may seem like a black box: some data goes in and a number comes out. Fortunately, the components and process are a…
Anti-Kickback Law in Healthcare – a comprehensive look
The U.S. Federal Anti-Kickback Statute (AKS) is the governing law that prohibits any person or entity from knowingly and willfully offering, paying, or soliciting any type of remuneration for referrals….
Ransomware and HIPAA: trends and what to do
Ransomware attacks in the healthcare industry have become increasingly common in recent years, threatening patient care, disrupting daily operations, and possibly compromising protected health information (PHI). Under HIPAA rules, organizations…
What is the False Claims Act in Healthcare?
What is the relationship between the healthcare industry and the False Claims Act? Turns out, it is pretty intimate! In this Article … The False Claims Act – some background…
A Proposed HIPAA Rule Change for 2023
A proposed HIPAA Rule change for 2023 was an early Christmas gift from the Health and Human Services Department (HHS)! On December 21, 2022, HHS released a proposed rule covering…
Is Zoom HIPAA Compliant?
The Health Insurance Portability and Accountability Act (HIPAA) is the federal law that required the creation of national standards to protect sensitive patient health information. And the question “Is Zoom…
How to Open a Nursing Home: what you need to know
Contrary to popular notion, there are no “simple” steps to opening a nursing home. However, there are specific, essential elements that you must address. I’ve been a licensed nursing home…
Mastering the OIG Exclusion List
In this Article … What is the OIG Exclusion list? Who is on the OIG Exclusion list? What does it mean if an employee is on the OIG Exclusion List?…
What Methods are Acceptable for Destruction of PHI?
The Health Insurance Portability and Accountability Act (HIPAA) sets strict standards for the destruction of protected health information (PHI). PHI is any patient health information that can be used to…
Assisted living occupancy is up – time to jump in?
Assisted living occupancy is beginning to see a rebound in rates for 2022, after experiencing declines in 2020 and 2021. As of the second quarter of 2022, senior living occupancy…
Understanding the Penalties for HIPAA Non-Compliance
HIPAA violation penalties can be severe, and both healthcare providers and business associates need to be aware of the risks that come with violating HIPAA Rules. This article provides the…
Critical Access Hospital Compliance Plan
Is there anything particularly special about a Critical Access Hospital Compliance Plan? Not really; the same Office of Inspector General Guidance for Hospital Compliance Plans applies to critical access hospitals…
Hospital Compliance Program – Board Concerns
Hospitals commonly have a Hospital Compliance Program. Members of the Board of Directors read about problems or actual misconduct at other institutions. They want to know what the CEO is…
Hospital Market Analysis – 4 Areas of Focus
Your hospital is considering adding one or even several new business lines. You have been assigned the responsibility to analyze the market for these new business lines. You realize you…
What is a Corporate Integrity Agreement?
It seems these days the Office of Inspector General (OIG) of the Health and Human Services (HHS) Department is always busy with settlements or enforcements with healthcare providers. When the…