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QUALITY PAYMENT PROGRAM

2019 Performance Period Suppressed MIPS Quality Measures

In the 2019 Physician Fee Schedule Final Rule (83 FR 59847), the Centers for Medicare & Medicaid Services (CMS) established a policy that provides for the suppression of measures in certain circumstances. Starting with the 2019 performance period, for measures significantly impacted by clinical guideline changes or other changes where the CMS believes that adherence to guidelines in the existing measures could result in patient harm or otherwise cause misleading results as to what is measured as good quality of care, we will reduce the denominator of available measure achievement points for the quality performance category by 10 points for each impacted measure that is submitted by MIPS eligible clinicians and groups. Such policy will “hold harmless” any clinician or group submitting data on a suppressed measure. The measures identified… . . . read more.

Tool: COVID-19 Vendor/Rep Visitation Protocol Update

Sample Vendor/Rep Policy Update.

TOOL

Model COVID-19 Medical Screening Policy

Regulators have made it clear that given the unique circumstances of the COVID-19 pandemic, employers may implement pre-screening measures to ensure that people who have or may have the virus don’t get into work and spread it to others. But limits still apply and you can get into a lot of trouble if you don’t follow them. Here’s a Model Policy your lab can adapt that provides for the necessary privacy, health and safety, non-discrimination and other protections.

Focus On

Nearly 3 in 4 Physicians Say They Can’t Provide Easy & Rapid COVID-19 Testing

Development of new lab tests to detect the SARS-CoV-2 virus that causes COVID-19 coronavirus has been faster and more prolific than anybody could dare expect for a pathogen that was unknown just a few months ago. But it still may not be enough to satisfy the urgent demand for COVID-19 testing—at least not yet. That’s the depressing conclusion of a new survey from Harvard Medical School, the Rand Corporation and Doximity, a professional medical network of which 70% of US physicians are members Quick and Easy Testing Remains Elusive Conducted between March 21-24, the survey “Physicians Views on the Coronavirus Pandemic Response,” included 2,600 physicians. Half of the respondents said they’ve treated at least one patient with potential COVID-19 symptoms. When asked whether they were “currently able to test their… . . . read more.

Compliance

5 Ways to Avoid Kickback Risks When Placing Phlebotomists in Ordering Physician’s Offices

It’s not uncommon for labs to place a phlebotomist in a physician’s office to collect and process samples for testing. While not strictly illegal, this practice raises bright red flags under kickback laws. So, it’s imperative to carefully vet your in-office phlebotomist arrangements to ensure they don’t cross any kickback lines. Here’s how. The Legal Risks of In-Office Phlebotomist Arrangements The Anti-kickback statute (AKS) bans labs from offering or providing physicians anything of value to induce or reward the referral of patients covered by Medicare, Medicaid and other federal health care programs. The Stark Law and state antikick laws impose similar restrictions. The problem is that while you might not think of it as such, placing a phlebotomist inside the office of an ordering physician may constitute the kind of… . . . read more.

Compliance Tool: Model In-Office Phlebotomist Agreement

The following Model Agreement between a referring physician and a testing lab was created by Savannah, GA, lab compliance attorney Adam Walters and structured to minimize kickback liability risks to each party in accordance with the OIG 1994 Special Fraud Alert, which remains the definitive source of federal guidance on the subject. Speak to your attorney about adapting the model for your own use.

WORKPLACE SAFETY

COMPLIANCE: A 10-step compliance strategy for OSHA Recordkeeping Rules

January is the season when employers must compile their OSHA logs for the previous year. Here’s an overview of the OSHA Recordkeeping Standard and a 10-step strategy to ensure compliance. Step 1: Figure out if your office is covered Physician offices are among the industries listed by North American Industry Classification System (NAICS) as being partially exempt from the Standard (Section 1904.39), as shown below: Partially Exempt Industries by NAICS Code NAICS Code Industry 6211 Offices of Physicians 6212 Offices of Dentists 6213 Offices of Other Health Practitioners 6214 Outpatient Care Centers 6215 Medical and Diagnostic Laboratories 6113 Colleges, Universities and Professional Schools 8122 Death Care Services Result: You don’t have to keep OSHA injury and illness records (aka OSHA 300 Logs) for any establishment classified under the applicable NAICS… . . . read more.

TOOL: Model Employee Illness/Injury Reporting Policy

The OSHA Recordkeeping Standard requires you to record and potentially report work-related illnesses and injuries. Reporting of illnesses and injuries is also crucial to investigating, identifying and correcting problems that can lead to further incidents and OSHA violations. So, it’s crucial to establish a policy and procedure for workers to report workplace injuries and illnesses. You can adapt this Model Policy to ensure prompt and proper reporting of workplace injuries and illnesses.

ENFORCEMENT

Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme

You know that a branch of lab testing has gone from fad to mainstream when it becomes the subject of a major federal enforcement takedown. Accordingly, the newly announced breakup of a $2.1 billion genetic billing fraud scam, one of the largest Medicare frauds ever undertaken, signifies that genetic testing has officially arrived. Operation Double Helix Known as Operation Double Helix, this landmark investigation and prosecution was a joint HHS, DOJ and FBI crackdown carried out in five federal districts against 35 defendants associated with genetic testing labs (CGx) and telemedicine companies, including doctors, CFOs and CEOs that allegedly “capitalized on the fears of elderly Americans to induce them to sign up for unnecessary or non-existent cancer screening tests,” according to one of the U.S. Attorneys involved. Old Wine in… . . . read more.

WEBINAR RECORDING

The Medical Office Manager’s Guide to Advanced Hiring Techniques: Building Your Hiring Muscles

Presenters:

Paul Edwards
CEO and Co-founder
CEDR HR Solutions for Medical


Michele Oliver, SPHR
CEO and Co-founder
CEDR HR Solutions for Medical

Hiring is a critical task for every medical office manager … and sometimes it can seem hard – or nearly impossible – to find, screen and hire great employees … but that no longer needs to be the case!

. . . click here to view

 


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