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Provider Relief Fund: What does an audit mean to me?
Over the course of 2020, many providers received numerous rounds of Provider Relief Fund (PRF) money though the Coronavirus Aid, Relief, and Economic Security Act[1]...
NSF Misconduct Findings Carry Training, Other Requirements
During the second half of the previous fiscal year (FY), the National Science Foundation (NSF) disagreed with its Office of Inspector General’s (OIG) recommendation to...
Beware of risk adjustment practices that could put your health plan at risk
Welcome to the world of risk adjustment and Medicare Advantage!...
Palomar Health Settles CMP Case on Intensive Outpatient Psych Services
In another multimillion-dollar behavioral health care case, Palomar Health in California agreed to pay $3.084 million in a civil monetary penalty (CMP) settlement about billing...
OIG: Providers May Need Flexibility; Some Self-Disclosures Were Paused
The HHS Office of Inspector General (OIG) has been cutting providers some slack during the COVID-19 public health emergency, a top official said. That has...
The overcoming equation: Guiding an organization through HIPAA mishaps
You are a compliance professional on the day a fine has been imposed on your organization for a serious Health Insurance Portability and Accountability Act...
Coming into compliance with the Information Blocking Rule
On April 5, 2021, the 21st Century Cures Act Information Blocking Rule will become applicable.[1] In practice, this means that information-blocking actors—healthcare providers, health information...
CARES Act reporting obligations
The Coronavirus Aid, Relief, and Economic Security (CARES) Act provided needed pandemic financial relief for healthcare organizations. Entities receiving funding under the Coronavirus Response and...
Medical Group Pays $373,715 to Settle CMP Case on Supervision
Children’s Hospital Los Angeles Medical Group has agreed to pay $373,715 to settle allegations it billed for radiology services performed by residents without “appropriate” supervision,...
Telemedicine after COVID-19: What happened and what's next?
The deadline for this article fell on December 2020. At that time, the world eagerly awaited the broad distribution of vaccines that would stop the...
