Are You Defrauding Medicare By Either Upcoding Or Downcoding Submitted Claims?
Both upcoding and downcoding are significant because these actions have been interpreted as a basis for abusing and defrauding the federal government and its programs. According to CMS, “abuse describes practices that, either directly or indirectly, result in unnecessary costs to the Medicare Program.” Abusive coding practices include: Upcoding – a code with a […]
Read MoreCan You Compete Against A Noncompete Clause?
Do you have an existing noncompete clause in your contract or are looking to enter into such a contract? If so, you should read the full article from Physicians Practice. While addressing physicians, the information in this article is applicable to any healthcare provider being asked to sign a noncompete. In most states, some form […]
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Category: Professional Development
Are You Properly Maintaining Patient Records As Required by Michigan Law?
In a rare announcement, the Michigan Department of Licensing and Regulatory Affairs (“LARA”) announced that it has been receiving complaints from consumers who are unable to obtain their medical records from health care providers. LARA has recently published a reminder to licensed or registered health care providers of their obligation to keep and maintain records […]
Read MoreCould A Sweetheart Contract Or Lease Turn Sour?
Last week the United States Department of Justice announced a settlement agreement with William Beaumont Hospital, located in the Detroit area, based on allegations Beaumont made false claims to the Medicare, Medicaid, and TRICARE programs. The allegations are based on improper relationships with eight referring physicians. Under the settlement agreement, Beaumont is required to pay […]
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Post Tagged with Donna Craig, False Claims Act, Fraud & Abuse, Medicare, Physician, Stark Law, The Health Law Center Have You Taken Adequate Steps to Thwart Phishing Emails? If Not, You Could Be Facing A HIPAA Breach.
For the second time in 2018 UnityPoint Health announced that it suffered a HIPAA data breach that could affect the medical and financial information to as many as 1.4 million patients. That information suspected of being disclosed could include patient names, birth dates medical record numbers, medical information, insurance information, and Social Security and driver’s […]
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Category: HIPAA
Are You Productive In The Office? If Not, Learn How To Address Common Efficiency Killers
At Marysville Primary Care, the physicians have a good idea of what awaits them each day before seeing their first patients. The four doctors at the Ohio-based practice take a look at their schedule at least one day ahead of time, communicating any concerns with two nurse practitioners and other staff members — all in the name of increased efficiency.
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Category: Professional Development
Post Tagged with Advance Practice Registered Nurse, Donna Craig, Health Professionals, Physician, The Health Law Center Patients Can Not Sue For Breach Of HIPAA Privacy Rule
The United States District Court is the most recent court to rule on whether a patient has a right to sue a health care provider when the privacy of protected health information is breached. Consistent with previous court decisions, the U.S. District Court for the District of Columbia concluded that HIPAA does not grant […]
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Category: HIPAA
Post Tagged with Centers for Medicare & Medicaid Services, Donna Craig, HIPAA, Privacy Rule, The Health Law Center Now’s Your Chance To Tell CMS How You Feel About The Stark Law!
The Centers for Medicare & Medicaid Services (“CMS”) is seeking public input on how the Stark Law may be impeding patient care coordination. CMS issued a “Request for Information” seeking comments from providers that participate in alternative payment models (value based programs vs. fee for service) that may require the need to revise or […]
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Category: Medicaid, Medicare, News & Updates
Post Tagged with Centers for Medicare & Medicaid Services, Donna Craig, Medicare, Stark Law, The Health Law Center Texas Supreme Court Finds Xerox, Not Dentists, Responsible For Fraudulent Medicaid Dental Payments
The Texas Supreme Court recently upheld a Texas Court of Appeals ruling that Xerox was responsible for the $1 billion in fraudulent Medicaid dental payments. The state found that Texas Medicaid and Healthcare Partnership, a subsidiary of Xerox, allowed workers with limited expertise to approve dental claims for the state’s Medicaid program. Xerox, which was […]
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Category: Anti-Kickback Statute, Medicaid, News & Updates
University Of Texas MD Anderson Cancer Center Must Pay More Than $4.3 Million For HIPAA Violations
An Administrative Law Judge (ALJ) ruled that MD Anderson Cancer Center must pay more than $4.3 million in civil monetary penalties for violating HIPAA Privacy and Security Rules. The ruling is based on three separate data breaches in 2012 and 2013 that involved the theft of an unencrypted laptop from a MD Anderson physician’s home […]
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Category: HIPAA
Post Tagged with Centers for Medicare & Medicaid Services, Donna Craig, HIPAA, Privacy Rule, Security Rule, The Health Law Center 
