Protected health information

Protected health information

Tuesday, September 15, 2015

Did you know that HIPAA (Health Insurance Portability and Accountability Act) requires special care surrounding patient medical records? While health information is used broadly to positively impact care, this Protected Health Information (PHI) lists 18 identifiers that must be safeguarded or else the entity failing to protect that information can be subjected to sanctions, lawsuits and fines....

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Overpayments Are an Obligation to Refund

Overpayments Are an Obligation to Refund

Tuesday, September 15, 2015

Did you know that healthcare providers are legally compelled to return overpayments as part of their compliance efforts? The Patient Protection and Affordable Care Act (PPACA) includes a civil monetary provision that requires the return of overpayments within 60 days of identification by the provider. Re...

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How Medicaid Coverage For Doula Care Could Improve Birth Outcomes, Reduce Costs, And Improve Equity

How Medicaid Coverage For Doula Care Could Improve Birth Outcomes, Reduce Costs, And Improve Equity

Tuesday, September 15, 2015

Did you know that nearly 4 million U.S. women give birth each year, and approximately half of these births are financed by state Medicaid programs? About 99 percent of American infants are born in hospitals, at a total cost of more than $27 billion annually. The treatment intensity provided in a typical hospital-based childbirth in the United States has drawn scrutiny in past years, and particularly so over the past several weeks....

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National Provider Identifier

National Provider Identifier

Tuesday, September 15, 2015

Did you know that every medical provider in the country is assigned a unique identifier like a social security number, referred to as an NPI number (National Provider Identifier)? This is used to track that provider’s activity, and is used for government reporting to track questionable payment patterns.Read More

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UNC Hospitals accused of overbilling Medicare by $2.5 million

UNC Hospitals accused of overbilling Medicare by $2.5 million

Tuesday, September 15, 2015

Did you know that major hospitals face increased scrutiny of their internal controls and billing systems? These typically take the form of targeted audits conducted by the watchdog agency for Health and Human Resources (Office of Inspector General). Medicare recently accused UNC Hospitals of overbilling the federal insurance program by approximately $2.5 million, and are demanding repayment from the Chapel Hill health care organization. ...

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Courts prove tough crowd for consolidating providers

Courts prove tough crowd for consolidating providers

Tuesday, September 15, 2015

Did you know that federal courts are challenging physician deals by health systems on antitrust grounds, asserting that these consolidations are anti-competitive? Idaho-base St. Luke’s Health System was convicted of violating state and federal antitrust laws when it acquired a medical group in 2012. This was a major victory for the Federal Trade Commission, which is stepping up its enforcement efforts in this regard....

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