With the continued proliferation of qui tam False Claims cases showing no signs of slowing down, not only must providers consider the amount of any monetary settlements, they must also consider whether the Office of Inspector General for the Department of Health & Human Services ("OIG") will require a corporate integrity agreement ("CIA").
The Alabama Hospital Association has launched the ALhealthmatters campaign, highlighting the importance of expanding Medicaid in Alabama.
The Department of Health and Human Services announced a historically large $16 million HIPAA settlement with Anthem, Inc. following its investigation of the equally historic 2014 breach affecting almost 79 million people. Is this an enforcement trend?
In this day and age, where a vast amount of information is stored electronically and you can buy almost anything with a "one-click" purchase, it comes as no surprise that cyber-incidents are on the rise, especially among healthcare providers.
To facilitate the American healthcare system's transformation from volume-based to value-based payment, CMS is requesting public comment regarding its newly proposed rule that would shift the amount of risk that participants in Accountable Care Organizations (ACOs) assume under the Medicare Shared Savings Program (MSSP).
Many Alabama providers participated in the Quality Payment Program in 2017, under MIPS (Merit Based Incentive Program). A handful participated in a MIPS APM (Alternative Payment Model), which is a baby step towards alternative payments, but still left the participants free from downside risks.
Sunlight provides the energy that powers all life on earth. However, those radiant waves also have a darker side. They are a leading suspect in cellular changes that lead to melanoma, a cancer that can rapidly become lethal as it moves into surrounding lymph nodes and beyond.
"We have a problem with patients disregarding their medical provider, and that shows in many ways," says Maddox Casey, CPA, MBA, with Warren Averett healthcare division.
Only 4,177 rural health clinics (RHCs) exist in the entire U.S. A little over one hundred of those reside in Alabama.
CMS is proposing big changes in the physician fee schedule and quality payment program for 2019
On July 23, 2018 the United States House of Representatives passed HR 1676 approving grants to improve educational programs, research and workforce development in palliative medicine.
In an effort to provide more options in the insurance marketplace, the Trump Administration is making it easier for small businesses to form association health plans. These plans allow multiple small employers to band together to provide health insurance for their employees. By purchasing or providing insurance through an association, small businesses can take advantage of the leverage and economies of scale usually reserved for larger groups.
"We have 17 providers, but only four phone operators, all because of our patient portal," says Clay Barnett, director of internal programs at Birmingham Internal Medicine Associates (BIMA). This tech allowed them to add four physicians in the last two years without the expense of hiring any additional phone support.
The days of stealing personal information for credit cards no longer holds the greatest appeal for hackers of medical facilities. "Credit card companies stand behind their clients," says Russ Dorsey, manager of information services at Kassouf & Co. Purchases are rapidly questioned, cards are voided, and card holders rarely get dinged.
Improved efficiency and communication are at the heart of blockchain technology, offering great promise for the healthcare industry to realize improved outcomes in both a business and clinical setting.
Girders, cranes, and concrete are a familiar sight around UAB, especially now with three new construction projects underway on the medical side alone.
There are many questions to consider when determining where to locate or move a practice.
In 2016, the United States Supreme Court issued its decision in Universal Health Servs. v. U.S. ex rel. Escobar which dealt, in part, with how the "materiality" requirement should be enforced in False Claims Act ("FCA") cases.
You may have heard a lot lately about GDPR lately and thought "Why should I care? It probably won't affect me or my business."
"The methodology was flawed to begin with," says Danne Howard, chief policy officer with Alabama Hospital Association (AlaHA), about Medicare's method for calculating the reimbursement rate for hospitals, especially rural facilities. "But it's become even worse."
On June 1, 2018, any person or business that acquires or uses personally identifiable information of an Alabama resident, or contracts to maintain, store, process or access such information, may be subject to The Alabama Data Breach Notification Act of 2018.
I recently attended a conference in Las Vegas where I caught up with colleagues who specialize in healthcare operations and business strategy.
AAMC calls for a multi-pronged approach to address the looming physician shortage.
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