Audits, Healthcare | JD Supra Law News

Self-Audit Results Found Sufficient to Sustain False Claims Act Complaint

by Robert Mazer | Ober|Kaler on 5/2/2013

District Court Finds That Medical Group’s Failure to Further Investigate Audit Results May Violate Requirement to Return Overpayments - Background - Internal audits of third-party payment claims – frequently...more

Hospitals: Audits And Compliance

by Michael Volkov on 4/2/2013

Hospitals are under intense scrutiny. The federal government knows that one sure way to reduce healthcare costs is to get hospitals to lower their costs. Hospitals feel the pinch given the need to generate revenue but know...more

CMS Focuses on Fraud Associated with Increased Use of Electronic Health Records

by Tom Crane | Mintz Levin - Health Law on 3/22/2013

Acting CMS Administrator, Marilyn Tavenner, recently reaffirmed the agency’s concern that the increased use of electronic health records (“EHRs”) has contributed to increases in fraudulent billing practices by providers. At a...more

DOL Audits Of Employer-Sponsored Group Health Plans Now Include Healthcare Reform Compliance

by Kelley E. Kaufman | McNees Wallace & Nurick LLC on 3/18/2013

The U.S. Department of Labor (the "DOL") has recently enhanced its enforcement activities with respect to group health plans by significantly increasing the number of audits it is conducting. In addition, the DOL's audit...more

Protecting Your Hospital From Over-Utilization Prosecutions

by Michael Volkov on 2/22/2013

The government has been increasing its focus on healthcare fraud involving “quality” of care. This is an extremely difficult issue, especially for prosecutors. It is very difficult to define “quality” standards and then...more

Audits, Audits And More Audits: Life In The Healthcare Industry

by Michael Volkov on 1/13/2013

Healthcare suppliers and service providers live in a regulated world. They are constantly under audit scrutiny. Sometimes federal agencies (i.e private contractors) conduct the audits; other times state agencies conduct the...more

Utilizing the HIPAA audit protocols as a compliance tool By Kimberly J. Gold

by Kimberly J. Gold | Mintz Levin - Health Law on 12/6/2012

Originally published in Compliance Today on December 1, 2012. ..Covered entities are now subject to privacy and security audits by OCR. ..OCR published audit protocols regarding its standards for such...more

Meaningful Use Mash-Up: Update on Deadlines, Changes for Stage 2, and the Start of MU Audits

by Davis Wright Tremaine LLP on 10/2/2012

The march towards electronic health records (“EHRs”) and health information exchange continues. It is worth noting a number of recent changes to the Medicare and Medicaid Meaningful Use programs governing incentives for...more

HHS Publishes Roadmap for HIPAA Audits .

by Epstein Becker & Green, P.C. on 8/16/2012

One of the less well-known provisions of the Health Information Technology for Economic and Clinical Health (or "HITECH") Act[1] is the requirement that the U.S. Department of Health and Human Services ("HHS") periodically...more

Are You Ready? HIPAA Audits Are Here.

by Trenam Kemker on 8/13/2012

As part of health care reform, the federal government mandated that a pilot HIPAA audit program (the “HIPAA Audit Program”) be developed to ensure compliance with HIPAA’s privacy and security rules and its breach notification...more

Federal Government Releases Protocol for HIPAA Privacy, Security and Breach Notification Audits

by Trenam Kemker on 8/13/2012

On June 26, 2012, the Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) released on its website the protocol that it has developed to serve as a guideline for recently-implemented HIPAA...more

OCR Releases HIPAA Audit Protocol

by Morgan Lewis on 7/23/2012

Protocol provides clues regarding areas of focus for ongoing HIPAA audits assessing compliance with the Privacy, Security, and Breach Notification Rules. The Office for Civil Rights (OCR) at the Department of Health...more

Shorts on Long Term Care - May 2012

by Poyner Spruill LLP on 5/9/2012

In this issue: - A Sign of the Times: Nonpayment of Resident Accounts, Transfer/Discharge and Related Issues - Responding to an Audit? Be Prepared! - Ken’s Quote of the Month An excerpt from...more

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Audits › Healthcare