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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.

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.

TERMINATION

To avoid a messy workplace theft investigation, can we just fire our prime suspect?

By Lynne Curry Question: Several years ago, when one of our employees was stealing from other employees’ purses and lockers, we called the police. The process — calling the police, alerting our insurance carrier and interviewing multiple employees to show fairness so we wouldn’t get sued for wrongful termination when we fired the one employee — tore apart our company. Some of our best employees couldn’t believe we didn’t trust them. We tried to explain we had wanted to be fair, and that if we only singled certain employees, we’d stigmatize them forever, but two of our best, long-term employees were so angry they quit within a few months. Once again, we have a problem. Several employees have reported missing small things from their desks. These items appear to be… . . . read more.

HIRING

3 things to know about background checks

“No, we didn’t do a background check on her before we hired her. She seemed like such a nice person.” “Well, I just ‘Googled’ him, and it looks like he has some sort of criminal record, but I can’t see what it is.” These are things we occasionally hear from our members on the topic of background checks. Although nobody wants to think the worst of every applicant, it just makes good business sense to look into a person’s background before you make them your employee. This is especially true when you are hiring someone who will have access to your company’s financial records and/or to patient financial information such as social security and credit card numbers. A call that we hate to get, but we do get occasionally, is… . . . 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.

DATA SECURITY

4 ways your managed IT provider can help with HIPAA

By Ron Slyker Healthcare IT can best be explained  as technology that allows the secure exchange of medical and patient information between healthcare providers, patients, insurers, and other administrative operations. With the rapid increase of healthcare companies adopting cloud technology to share files and store private data, the need to involve managed service providers to assure full compliance of HIPAA is essential. Here are four ways that your managed services IT provider should be expected to help maintain HIPAA compliance: Encryption. Your managed services provider should make sure that all your devices—including laptops, tablets, and mobile devices—are encrypted. This is the best way to secure your data. And, given that mobile malware is on the rise, you will want to make it a top priority. Set up a reporting process…. . . . read more.

RISK MANAGEMENT

How to handle office romance in 2022

By Lynne Curry Three potential hot messes. In company Z, a senior manager considered his workplace a dating pool in which he fished. When he put the moves on a new female employee, the workplace grapevine ignited. In company Y, the head of marketing had serial crushes on one after another of the male management trainees. Because she was attractive and personable, several of them developed crushes in return. One put the moves on her when they worked all weekend on a project. In company X, the Chief Operating Office and Chief Financial Officer had a not-so-secret affair. Although he hated to, the Chief Executive Officer called them into his office and said, “One of you needs to resign. Unless this happens, we’ll have no defense if we fire someone… . . . read more.

TOOL

Love contracts: Help for hot messes

They arrive at work separately. They never touch each other in your presence. Then, as you chair a meeting, you see his gray eyes seek hers out across the conference table. She returns his gaze; her eyes linger. Suddenly you know. The senior manager, despite all the sexual harassment seminars he’s attended, appears romantically intertwined with an accounting clerk. If you’re in charge, how do you handle this hot mess?  The reality Some managers and supervisors would never have an affair with an employee they oversee or an employee in their company. Others consider the workplace a dating pond in which they fish. Still others fall into a relationship that makes them disregard risks. According to a recent survey by the Society for Human Resource Management, one in three U.S…. . . . read more.


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