The PHE was renewed another 90-days effective April 16, 2022, but what 1135 Waivers expired?The PHE, Public Health Emergency has been extended another 90-days through July 19th, 2022. However, many Waivers for SNF and LTCF are expiring in 30-60 days, and Physicians crossing state lines, treating patients, via virtual care, need to know what the current rules are.
Diving in to the SRDPHealth care providers and suppliers face a dilemma when they identify that potentially problematic claims have been submitted to a federal health care program (i.e. Medicare, Medicare Advantage Programs, Tricare and Medicaid Programs, ). Balancing legal disclosure obligations and business interests can be difficult when entities look at short term risks and benefits, to disclose to the OIG or CMS or simply, voluntary refund the overpayment to the provider’s Medicare Administrative Contractor.
Are you a HIPAA entity?
If you have heard the acronym HIPAA thrown around a lot lately, you are probably thinking, “Do I really know what HIPAA means?”. So many are throwing that term around in the falsehood that their legal or privacy rights are being violated in some way as more and more companies are requiring COVID-19 vaccinations.
Kickbacks, False Claims and Billing for a Suspended DoctorIn an update from the Doctors Management Compliance Guy Blog, Sean Weiss discusses the $37.5 million pay to settle allegations of kickback billing for a suspended physician and false claims. Weiss believes that this is a failing of the Department of Justice due to the connection of this bad-actor physician and the Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General.
Interim Final Rule for Surprise BillingNSCHBC member Amanda Waesch walks readers through the newly issued interim final rule which safeguard patients against unforeseen medical bills arising from out-of-network care as part of the implementation of the new bipartisan No Surprises Act. Waesch also details what this rule means for patients, providers, specific health plans, and the rule’s requirements related to surprise billing.
Leadership in Healthcare: Identifying leaders within your staff and fostering growthIn this NSCHBC original article, our expert thought leaders discuss the current state of healthcare leadership, and how practice management can hire potential leaders and train staff to foster their growth as an investment into their healthcare business.
OIG Advisory Opinion on Spinal ImplantsIn this latest Doctors Management update, Sean Weiss discusses the new Advisory Opinion on spinal implants provided by OIG, or the Office of Inspector General. Here, Sean details the proposal where spinal implant manufacturers would offer a reduced price to hospitals under specific conditions, and if the proposal constitutes grounds for the imposition of sanctions.
It’s time to add NPPs to your Practice: How to make them cost effective and profitable – Part 1Adding Non-Physician Providers (NPP’s) such as nurse practitioners (NPs) and physician assistants (PAs) can substantially increase a primary care, specialty and/or surgical practice’s profitability and access by improving patient care and providing additional availability for appointments and practice hours in order to reduce fixed costs per provider and increase profitability for the physician owner.
HHS/OIG Exclusion List ViolationsIn the latest Compliance Guy blog post, Sean Weiss discusses the OIG exclusion list, or the Inspector General's List of individuals and entities excluded from participation in Medicare, Medicaid, and all other Federal health care programs, and how healthcare organizations are responsible for verifying their potential employees’ ability to hold employment and vetting any vendors.
Bill of Health: Take charge of patient-friendly debt collection
In his latest article for CMA Today, Mark Harris interviews NSCHBC president David J. Zetter for his thoughts on how medical practices should update their approach to both financially motivated patient interactions and billing in order to avoid or reduce the need to pursue out-of-pocket charges for services already rendered.