Tag archive: denise bloch

CMS Update – Sharp Rise in Denials for SNF Claims

CMS issued an update regarding what appears to be a sharp increase in the denial rate for Skilled Nursing Facilities (SNFs) as reported in the 2015 Comprehensive Error Rate Testing (CERT) Report. The CERT Report showed denials increasing from 6.9% reported in 2014 to 11% in 2015. What did CMS attribute as the cause of…

HIPAA Update – Reminder for your Clients – 2016 HIPAA Breach Reporting Deadline is 3/1/17

As a helpful reminder, clients need to be aware that the March 1, 2017 deadline for reporting 2016 HIPAA breaches is fast approaching. March 1, 2017 is the Deadline for Reporting 2016 HIPAA Breaches Affecting Fewer than 500 Individuals by Covered Entities to the OCR. Click here for a link to the OCR portal to…

HIPAA Update – Newest Settlement of $475,000 Results From Untimely Breach Report

Don’t let your clients get caught paying a “big” settlement for failing to report a HIPAA breach! For the first time, the Office of Civil Rights (OCR) has announced a HIPAA settlement with a provider who failed to provide a timely breach report. Presence Health, a health network serving Illinois with approximately 150 locations, including…

New Final Rule for National Emergency Preparedness for Medicare/Medicaid Providers & Suppliers

Following recent natural disasters, such as Hurricane Sandy or episodes of serious flooding; the Centers for Medicare and Medicaid Services (CMS) published a Final Rule to help Medicaid & Medicare providers and suppliers plan for natural and man-made disasters. The new regulations provide consistent emergency preparedness requirements with a goal of enhancing patient safety during…

Fraud and Abuse Update: Inflation Adjusted Rate Hikes Coming Aug. 1 for False Claim Act and Anti-Kickback Civil Money Penalties

PROVIDERS TAKE NOTE: CIVIL MONEY PENALTIES FOR FALSE CLAIM ACT AND ANTI-KICKBACK STATUTE VIOLATIONS WILL NEARLY DOUBLE AUGUST 1ST The Department of Justice (DOJ) released an interim final rule recently to update the minimum and maximum civil money penalties (CMP) for violation of the False Claim Act (FCA). Providers should be aware that the increases…

HIPPA’s Not Just For Covered Entities – Recent Enforcement Action Extends To Business Associates

On June 29, 2016, the Office of Civil Rights (OCR) announced a Resolution Agreement it entered with Catholic Health Care Services of the Archdiocese of Philadelphia (CHCS) a business associate of six nursing homes. This Resolution Agreement included a monetary payment of $650,000 and a Corrective Action Plan (CAP). The CAP requires CHCS to conduct…

Massive National Health Care Fraud Takedown

Last week, the OIG reported charges against 301 individuals for approximately $900 Million in false billing as part of the largest false claim takedown. The takedown focused on a broad range of providers including home health companies, physicians, physical and occupational therapy clinics, infusion clinics, mental health providers, DME suppliers, and compounding pharmacies. Of importance,…

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