For those who doubt the possibility of OIG enforcement regarding fraud and abuse violations, the OIG Semi-Annual Report lists the following enforcement results:
$2.8 billion on audit and investigative receivables;
3,806 individual and entity; receivables;
537 criminal actions; and
262 civil actions
Electronic Health Records (EHR) are touted by proponents within the healthcare industry as a means to both improve quality and reduce cost through a combination of reduced errors and improved communication. The drive to standardize the process for the utilization of electronic healthcare records gained its greatest impetus from the electronic transaction standards of HIPAA,…
HHS/CMS announce ePrescribing regulations. The Department of Health and Human Services and CMS issued a final rule for ePrescribing standards. The final rules were published in the Federal Register under November 7, 2005 at 70 FR 67568.
Highmark announces the Highmark E Health Collaborative. The Highmark E Health Collaborative is a joint project between Highmark and the Pittsburgh Foundation to foster the adoption and utilization of electronic prescription systems. The Collaborative will provide funding to eligible physicians who wish to acquire and use electronic technology. Highmark will contribute $26.5 million , $18.5…
JCAHO has posted a field review notice regarding hospital Medical Staff credentialing in privileging standards. The proposed standards would establish additional evidence based processes for the determining the competence of practitioners. See the JCAHO website link for the field review.
The centers for Medicaid and Medicaid Services (CMS) reported today that quality of care has improved significantly in hospitals participating in the premier hospital quality incentive demonstration project, a groundbreaking Medicare pay for performance demonstration project. The press release was posted on the CMS website on
November 14, 2005.
The Pennsylvania Insurance Department announced on October 31, 2005 that the 2006 MCARE assessment will be 29% of the primary prevailing premium. Earlier in the week, Pennsylvania Governor Ed Rendell promised extending the MCARE abatement program for 2 more years.
Several hundred medical malpractice cases settled or adjudicated by the Department of Health and Human Services between 1997 and 2004 were not reported to a national repository of provider data, the HHS Office of Inspector General said in report released Oct. 19.
Continue Reading Malpractice Cases Not Reported
The final rule from the Medicare Physician Fee Schedule revises the Stark definition of designated health services (DHS) to include diagnostic and therapeutic nuclear medicine services. Since this change will impact existing relationships, this portion of the rule has a delayed effect date, i.e. January 1, 2007.
Physicians often ignore crucial early warning signs in the credentialing process. Physicians also sometimes ignore the fact that the credentialing process is a structured legal process which can trap the unwary and penalize the careless. Here are 10 mistakes physicians make during the process, along with advice on how to prevent them.
Continue Reading 10 Biggest Mistakes Physicians Make In The Credentialing Process
