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WORKING WITH PATIENTS

Prevent losing your patients by focusing on these 4 areas

By Nick Hernandez bio The changes to the healthcare industry are increasingly focused on addressing patients as consumers. Such a change means that providers must, of course, emphasize quality and work toward price transparency, but they must also seek to determine what patients desire most. It is this last effort that is transforming the healthcare sector more like businesses of other sectors; what consumers want, is what drives competition and ingenuity (and oftentimes commoditization). Perhaps more than ever, physicians need to be focused not just on attracting more patients, but also on not losing the patients they have. Under the healthcare reform legislation, the federal government views patients as consumers. Consequently, national attention has been placed on the patients as consumers, and that attention has not gone unnoticed. Indeed, patients… . . . read more.

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.

INFORMATION SECURITY

HIPAA enforcement takes a dramatic new direction

Historically, HIPAA enforcement has focused predominantly on the failure of covered entities to keep protected health information (PHI) private and secure; but now the scope is broadening to encompass keeping PHI too private and too secure. The HHS Office for Civil Rights (OCR), the agency that enforces HIPAA rules, has broken new ground by fining a Florida hospital for failing to provide access to PHI to the individual it relates to. Here’s a look at the case and what it portends about the new direction in HIPAA enforcement. The HIPAA Right of Access When you hear the term “HIPAA Privacy Rule,” the first thing likely to jump into your mind is the obligation to keep PHI secure and refrain from disclosing it to third parties without appropriate authorization. But there’s… . . . read more.

COMPLIANCE

Compliance officers must establish credibility with consistent, well-documented decision-making

One of the tougher issues a non-lawyer compliance officer faces is a challenge to their decisions and recommendations by other members of…


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HEALTH CARE REFORM

What every medical office manager needs to know about the Sunshine Law

Another product of the Affordable Care Act, the Sunshine Law (also called Open Payments) begins implementation this year. The law requires manufacturers and…


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INSIGHT

What makes a successful practice manager

By Shane Carter  bio
Being a practice manager in today’s healthcare environment is a very tough job. Disruptive and transformational change is underway in health care delivery. The modernization of…


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QUALITY PAYMENT PROGRAM

New Quality Payment Program resources are now available

The Centers for Medicare & Medicaid Services (CMS) has recently posted the following new and updated resources on the…


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HEALTH INSURANCE EXCHANGES

2018 Health Insurance Exchanges Issuer County Map

The Centers for Medicare and Medicaid Services has posted an update to the Health Insurance Exchanges Issuer County Map. This map is of projected…


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HEALTH CARE REFORM

How to determine your MIPS participation status

Are you unsure of your participation status in the Merit-based Incentive Payment System (MIPS)…


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HEALTH CARE REFORM

Watch for your MIPS participation status letter

The Centers for Medicare & Medicaid Services is reviewing claims and letting practices know which clinicians need to take part in MIPS, the Merit-based Incentive Payment System. MIPS is…


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