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A Bunch of Bad Apples Keep Home Health Agencies Away

CMS, Affordable Care Act

It pays to play nice and when others don’t, CMS can put a big bite in the potential for new Medicare and Medicaid providers. If this is news to you, it is to most people. 

Top 3 Reasons to Self-Disclose to the OIG

self disclose

You might hesitate to self-disclose fraud and exclusions to the OIG due to the time-investment and immediate fines; however, according to the OIG the process does not take as long as you might think. 

Survey Says: Verifying Staff Credentials is Most Challenging

Recently, the Joint Commission released a chart of the most challenging requirements for health care organizations.  Interestingly, for Behavioral health care companies, HR 01.02.05 Standard proved to be one of the more challenging compliance standards to meet. See chart.

CMS/PPACA Compliance Advice- Do Monthly Exclusion List Checks

OIG Exclusion

Using funds allocated as part of healthcare reform (Affodable Care Act), CMS (Center for Medicare & Medicaid Services) has stepped up efforts to locate and stop medicare fraud nationwide. As quoted from a recent Business Wire article, Donovan Ayres, Vice President of Regulatory Compliance at Clear Vision Information Systems, "CMS is being more aggressive than ever in making sure that all Medicare Advantage plans are in full compliance."

OIG Review of State Medicaid Fraud Control

The OIG recently recently its 2012 review of the Louisiana State Medicaid Fraud Control Unit.  Among other findings, the review found that 14% of sentenced providers were not referred to the OIG for exclusion within the appropriate time period ("30 days or other reasonable time period" according to Performance Standard 8(d)).  These providers were not reported to the OIG until after the review.

OIG in 2013: Detecting Fraud and Abuse and ACA compliance

describe the image

Each year the OIG releases a summary of the most significant management and performance challenges facing HHS.  These challenges reflect the continuing vulnerabilities that the OIG has identified as emerging issues that HHS will face in 2013. Here are the Top 10 (as David Letterman would say):

Affordable Care Act: Review Your Compliance Plan

Affordable Care Act Legislation

After last nights' election results, one thing is clear-the President's plan for healthcare reform is here to stay.  Although many questions remain of its financial impact, no one ever doubted that the compliance and enforcement features of the federal legislation made for bad law.

Joint Commission HR Standards: Are You Audit Ready?

Joint Commission Logo

Ever wonder if today is the day that the Joint Commission shows up to begin its audit of your HR practices? How will you confidently demonstrate compliance with HR standards 01.02.01 with regard to staff qualifications and 01.02.05 with regard to verification of qualifications?

Growing Job Opportunities in Healthcare Industry

describe the imageIt is estimated that 30 million people will gain healthcare insurance coverage under the Affordable Care Act. With this surge of new patients will come a guaranteed need for healthcare professionals. According to HealtheCareers' 2012 Q2 Jobs Report, jobs across all specialties in healthcare are expected to grow over the next eight years.

Physicians account for 40% of all healthcare job openings in Quarter 2, however, there has only been a 1% growth in openings for physicians since Quarter 1. Currently, the biggest increase in job openings since Q1 has been for nurses. The demand is especially high for seasoned nurses, considering 90% of all nursing positions require more than one year of experience. As older generations of nurses begin to retire, the need for skilled nurses will be in an even greater demand.

Nurse Practitioners and Physician Assistants have had an equal increase in job openings since Q1 at 16%. Both are valuable resources during physician shortages; their salaries are less than physicians and most states grant these healthcare professionals the power to write prescriptions. 

As more hospitals and healthcare facilities transition to electronic medical records, it is no surprise that Healthcare IT positions are on the rise. Openings increased by 18% with 30% of those openings specific to HIT analysts/system analysts.

"HealtheCareers collected their data from their online database of job openings from April 1 through June 30, 2012. Given that their database is comprised of approximately 50,215 healthcare and medical job openings placed by 3,294 hospital and healthcare organizations, the report offers significant insight into industry trends in the job market:  Physicians and surgeons are still the top priority, but physician assistants, nurse practitioners and skilled nurses are all in higher demand as of Q2. Healthcare IT is growing, although it has yet to overtake healthcare provider needs."


For more information on HealtheCareers' Q2 Report read their blog.

Affordable Care Act Upheld: Monthly OIG Exclusion List Required

Affordable Care Act

The U.S. Supreme Court upheld the Patient
Protection and Affordable Care Act (commonly known as the Affordable Care Act). While most of the press is concentrating on the validity of the individual health insurance mandate, there is an important provision that was also reconfirmed today.

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