For the first time since 2012, the HHS Office of Research Integrity (ORI) issued
[1] an annual report, but for those used to previous updates or looking for useful details, it may prove to be a disappointment. Covering fiscal year (FY) 2020, the report consists mostly of graphics and presents essentially a snapshot of activities. Missing are trend data and any information from past years’ actions. ORI has a unique and crucial role in the research world: It investigates research misconduct, defined as fabrication, falsification or plagiarism, in the billions of dollars of studies supported by NIH and other Public Health Service (PHS) agencies.
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CMS’s supplemental medical review contractor (SMRC) has added outpatient therapy claims to its list of postpayment reviews, according to its website.
[1] The SMRC, Noridian Healthcare Solutions LLC, will audit claims with dates of service from Jan. 1, 2018, through Dec. 31, 2018.
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In a message posted April 15, HHS Principal Deputy Inspector General Christi Grimm reminded providers that vaccines should be administered free to patients.
[2] “OIG is aware of complaints by patients about charges by providers when getting their COVID-19 vaccines. Providers that charge impermissible fees must refund them and ensure that individuals are not charged fees for the COVID-19 vaccine or vaccine administration in the future,” she said. “Consistent with the CDC Vaccination Program, providers are permitted to bill third-party payers (such as Medicare, Medicaid, the HRSA [Health Resources and Services Administration] COVID-19 Uninsured Program, or a private insurer) for an admin
RTG Leaders Contribute to Healthcare Compliance Manual
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KNOXVILLE, Tenn., April 15, 2021 /PRNewswire/ Realty Trust Group (RTG) leaders had the unique opportunity to publish an article in the recently released Complete Healthcare Compliance Manual by the Health Care Compliance Association (HCCA). This all-in-one, comprehensive guide provides new and experienced compliance practitioners with guidance and insights on the fundamentals of program management, risk assessment, compliance training, auditing and monitoring, and much more.
Complete Healthcare Compliance Manual Healthcare organizations can t afford to let their compliance programs fall stagnant, says Gerry Zack, CEO, Society for Corporate Compliance and Ethics (SCCE) and HCCA. Risks are continually changing, so compliance programs must continually evolve to keep pace. The Complete Healthcare Compliance Manual is an essential tool for compliance professionals, wh
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Doctors Care P.A., the largest urgent care provider network in South Carolina, and its management company, UCI Medical Affiliates of South Carolina Inc., will pay $22.5 million to settle false claims allegations, the U.S. Attorney’s Office for the District of South Carolina said April 8.
[1] Doctors Care and UCI allegedly falsely certified that some urgent care visits were performed by providers who were credentialed to bill Medicare, Medicaid and TRICARE, which means the services weren’t performed by credentialed providers from 2013 to 2018, according to the complaint, the U.S. attorney’s office alleged. The case was set in motion by a whistleblower. Doctors Care and UCI didn’t admit liability in the settlement.
When employees are required to show their employers proof of a positive COVID-19 test before they get sick leave or a vaccination before returning to work, the implications are profound but they don’t enter the realm of the HIPAA privacy rule.
“It has nothing to do with HIPAA,” said attorney Kirk Nahra, with WilmerHale, at The Virtual Thirtieth National HIPAA Summit
[1] March 23. “HIPAA is not an overall health information privacy law. There have always been gaps in what was covered by HIPAA,” which have become more apparent with the advent of mobile apps, wearables and patient support sites.
The success of the health care system depends on data and protecting its privacy, but organizations are running into complicated situations that weren’t anticipated by the 2003 HIPAA privacy and security regulations. Although hospitals, insurers and clearinghouses are “reasonably comfortable with HIPAA rules,” he said, “we are seeing tensions.” One of the tensions involves