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COMPLIANCE

What does FMLA require of a medical office employer?

The Family and Medical Leave Act (FMLA) is one of the employment laws that protect your staff. It is a federal law that requires certain employers to provide their employees with up to 12 weeks of unpaid, job-protected leave per year for certain qualified medical and family reasons. For a medical office employer, the FMLA requires that they provide eligible employees with job-protected leave for the following reasons: The birth of a child or the placement of a child for adoption or foster care The care of an immediate family member (spouse, child, or parent) with a serious health condition The employee’s own serious health condition that makes them unable to perform the essential functions of their job Any qualifying exigency arising out of the fact that the employee’s spouse,… . . . read more.

COMPLIANCE

What does the Americans with Disabilities Act require of your medical office?

The Americans with Disabilities Act (ADA) requires medical offices to make reasonable modifications to their policies, practices, and procedures to accommodate the needs of individuals with disabilities, unless doing so would create an undue burden or fundamentally alter the nature of the services provided. This includes ensuring that the facility is physically accessible to individuals with disabilities, as well as providing appropriate communication accommodations and assistive technology. Specifically, medical offices must take the following steps to comply with the ADA: Physical accessibility: Medical offices must ensure that their facilities are physically accessible to individuals with disabilities. This includes installing ramps or chair lifts for individuals who use wheelchairs or mobility devices, providing designated parking spaces for individuals with disabilities, and ensuring that doorways and hallways are wide enough for individuals… . . . read more.

HIPAA

Proposed rule would standardize how to send health care attachments

It might get easier for your medical office to send healthcare attachments and electronic signatures. The Centers for Medicare & Medicaid Services (CMS), has issued a proposed rule, “Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard (CMS-0053-P).” If finalized, the proposed rule, would adopt standards for “health care attachments” transactions, such as medical charts, x-rays, and provider notes that document physician referrals, and office or telemedicine visits. The modifications to the HIPAA transactions would support both health care claims and prior authorization transactions, standards for electronic signatures to be used in conjunction with health care attachments transactions, and a modification to the standard for the referral certification and authorization transaction. The is a part of ongoing efforts to… . . . read more.

FEDERAL PRIVACY LAW

10 basic steps to comply with HIPAA

HIPAA (the Health Insurance Portability and Accountability Act) is a federal law that protects the privacy of individuals’ personal and medical information. HIPAA is important for medical offices because it sets standards for the protection and handling of this sensitive information, which is critical to maintaining the trust of patients and ensuring the confidentiality of their medical records. HIPAA requires medical offices to implement and maintain certain safeguards to protect PHI, including physical, technical, and administrative measures. These measures help to ensure that patient information is only accessed and used by authorized individuals, and that it is handled in a way that maintains its integrity and confidentiality. Non-compliance with HIPAA regulations can result in significant fines and legal consequences for medical offices, as well as damage to their reputation. Therefore,… . . . read more.

ENFORCEMENT

Physician and medical office to pay over $2.6M for false claims and kickback allegations

Allegations of improper billing and kickbacks have led to a penalty of more than $2.6 million for a Connecticut medical practice and physician. United States Attorney Vanessa Roberts Avery and Connecticut Attorney General William Tong announced that Feel Well Health Center of Southington, PC,  (formerly doing business as “Feel Well Health Center”) and Kevin P. Greene, M.D. (“Greene”) have entered into a civil settlement agreement with the federal and state governments and agreed to pay more than $2.6 million to resolve allegations that they violated the federal and state False Claims Acts by improperly billing federal and state healthcare programs, and that they received illegal kickbacks. Greene is a physician and the principal member and owner of Feel Well Health Center (now doing business as “Confidia Health Institute”), a primary… . . . read more.

COMPLIANCE

What to do when an employee uses FMLA to cover drinking

By Lynne Curry Question: We suspect one of our employees of using intermittent FMLA leave to cover her abuse of alcohol. We see a clear pattern. She takes leave two to three Mondays a month. Prior to her requesting FMLA leave, she claimed occasional sick days on Mondays. Other employees have noticed her leaving early on Fridays as well. With this fact pattern and given the rumors now circulating, may we start asking her to bring doctor’s notes each week to justify her need for Monday leave? Answer: While a Monday absence pattern may indicate alcoholism, you can wind up in legal hot water if you ask for weekly doctor’s notes from an employee using intermittent Family Medical Leave. In a landmark case, Oak Harbor Freight Lines v. Antti, the… . . . read more.

TOOL

Office safety inspection checklist

The examples outlined below do not list all the possible items for office inspections. The best checklist for your workplace is one that has been developed for your specific needs. Whatever the format of the checklist, provide space for the inspectors’ signatures and the date. Inspectors: Date: (O) Satisfactory (X) Requires Action Location Condition Comments Bulletin Boards and Signs Are they clean and readable? Is the material changed frequently? Do items interfere with people walking by? Floors Is there loose material, debris, worn carpeting? Are the floors slippery, oily or wet? Stairways and Aisles Are they clear and unblocked? Are stairways well lighted? Are handrails, handholds in place? Are the aisles marked and visible? Equipment Are guards, screens and sound-dampening devices in place and effective? Is the furniture in good… . . . read more.

TERMINATION

7 strategies for firing without backfiring

By Lynne Curry The final revenge of the difficult, fired employee. You’ve hesitated to fire him, you’ve given him chance after chance, but he’s not getting better. In fact, he’s getting worse, and so is the situation. You owe it to your other employees, who consider this employee toxic or carry his shirked workload burden, to bless this employee out the door. Unfortunately, you then make a critical mistake that results in a painful payout to this employee. If you want to fire without backfiring, you need to pay attention to: The doctrine of good faith and fair dealing; The guardrails of just cause, and Ask yourself 22 questions. If you’d like to fire an employee without backfire, you need to consider good faith and just cause, then ask yourself… . . . read more.

COMPLIANCE

4-step plan to return overpayments

Do you have to return plan overpayments? The short answer is, yes. Of course, you must return money that isn’t yours. In fact, to be compliant with Medicare and most commercial payers, once you discover an overpayment, you’ve got to refund it within 60 days. That’s the word from Michael J. Sacopulos, JD, founder and CEO of the Medical Risk Institute. “Sadly, I still speak with physicians who believe it’s okay to keep the money in the bank until the payer requests a refund. One large practice I work with told me they hadn’t run the credit balance report in nearly a year. When I suggested they do so, the Medicare credit balances alone totaled more than $300,000.” This is not the time to invoke “finders keepers, losers weepers,” he… . . . read more.

BILLING & CODING

Telehealth policy to change after the COVID-19 public health emergency

The COVID-19 public health emergency has been extended to Oct. 13. Of particular interest to medical practices is the continuation of telehealth flexibilities, which will expire at the end of the public health emergency. US Department of Health and Human Services Secretary Xavier Becerra officially renewed the declaration in mid-August. The emergency declaration has been in place since January 2020, and the latest renewal came as the Omicron offshoot BA.5, the most contagious variant yet, continues to stake its claim in the US. Daily case rates, though vastly undercounted, are the highest they’ve been in months, as are COVID-19 hospitalizations and deaths. Data published in August by the US Centers for Disease Control and Prevention shows that more than half of the country’s population lives in a county with a… . . . read more.


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