Four Habits of High-Value Health Care Organizations

The New England Journal of Medicine recently published an article regarding four habits of effective hospitals. Although the article is geared towards, hospitals, the principles below are applicable to any health care organization. Specification and planning – Base choices, transitions, subgroups, and patient pathway on specific, meaningful criteria. Infrastructure design – Create microsystems to meet the needs [...]

Why Should You Have a Compliance Program?

The Patient Protection and Affordable Care Act (“PPACA”) mandates in Sections 6102 and 6401 that a broad range of providers, suppliers, and physicians adopt compliance and ethics programs. By March 23, 2013, skilled nursing facilities and other nursing facilities must have “in operation” a compliance and ethics program that meets the PPACA’s criteria. Although the [...]

Institute of Medicine to Conduct Year-Long Study in HIT Safety

Under the HITECH Act of 2009, the Medicare and Medicaid electronic health record (“EHR”) incentive programs provide a financial reward for the meaningful use of qualified, certified EHRs to achieve health and efficiency goals. In July, CMS announced regulations outlining the initial requirements that eligible health care providers must meet to demonstrate meaningful use of certified EHR [...]

Court’s Texting Decision Shows Importance of Updated Policies

The United States Supreme Court considered an employer’s policies on e-mail and texting use in a decision issued on June 17. As reported previously in this blog, City of Ontario v. Quon raised the issue of whether a governmental employer who reviewed the content of text messages sent using an employer-provided pager had committed an [...]

New Wave of Legislation: Wage Theft Laws

A new type of wage and hour legislation is gaining steam around the country. Although you may not be familiar with the term “wage theft,” chances are good that you’ll be hearing more about it soon. What is wage theft? Generally, the term refers to an employer’s failure to pay wages when they are due [...]

Employee Texting Case Goes to Supreme Court

On Monday April 19, the U.S. Supreme Court is scheduled to hear a case that has important implications for employers who provide cell phone texting and other electronic communications tools to their employees. This case serves as a reminder to all companies to take precautions with electronic communications and the corporate policies that surround them: [...]

HIPAA Update

New rules increase penalties substantially and allow self-assessment for reporting. See the details here.

Can You Spot the Red Flags of Medical Identity Theft? FTC Rule Enforcement Now Begins November 1, 2009

The Red Flags Rule, designed to prevent and detect identity theft, takes effect August 1. Health care providers should carefully review the Rule’s definitions, because you may be surprised at how many health professionals are considered “creditors” who must develop Identity Theft Prevention Programs. The Red Flags Rule, 16 CFR § 681, applies to “financial [...]

New Review Process for Waiver Programs

The reviewers will be using standardized checklists as part of the new review process. The good news is that these checklists are available for providers and may be printed and used as internal QA.

Medicare Fraud Strike Force in Texas

According to the Houston Chronicle, there’s a federal Medicare fraud strike force on the loose in Texas. The article highlights a number of Houston-area clinics committing Medicare fraud. Medicare fraud in the U.S. last year totaled $2.35 billion. There were 575 health fraud criminal actions and 342 civil actions filed. The task force has reduced [...]

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