In light of concerns that patient photographs are showing up on social media networks and other multimedia messaging, CMS issued guidance to State Survey Agency Directors. S&C: 16-33-NH dated August 5, 2016, effective immediately, addresses the need for nursing homes to protect residents’ privacy. CMS stresses the importance to recognize each resident’s sense of self-worth and to create a respectful environment.
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Advocate Health Care Network, the largest fully-integrated health care system in Illinois, agreed to the largest HIPAA Settlement to be paid by a single entity for potential penalties in the amount of $5.55M. The alleged long term non-compliance resulting in this settlement included four failures to comply with HIPAA including: failure to adequately conduct risk assessments, failure to limit physical access to ePHI, failure to obtain Business Associate Agreements, andfailure to safeguard an unencrypted laptop from an unlocked car overnight.
On June 29, 2016, the Office of Civil Rights (OCR) announced a Resolution Agreement it entered with Catholic Health Care Services of the Archdiocese of Philadelphia (CHCS) a business associate of six nursing homes. This Resolution Agreement included a monetary payment of $650,000 and a Corrective Action Plan (CAP). The CAP requires CHCS to conduct a risk analysis and risk management, to develop and maintain written policies and procedures as well as to train all members of the CHCS workforce with access to ePHI within 60 days of the CAP in compliance with HIPAA, and to submit annual reports and attestation of CHCS’ compliance with the CAP for two years following the execution date of the Resolution Agreement.
Fraud and Abuse Update: Inflation Adjusted Rate Hikes Coming Aug. 1 for False Claim Act and Anti-Kickback Civil Money Penalties
PROVIDERS TAKE NOTE: CIVIL MONEY PENALTIES FOR FALSE CLAIM ACT AND ANTI-KICKBACK STATUTE VIOLATIONS WILL NEARLY DOUBLE AUGUST 1ST
Last week, the OIG reported charges against 301 individuals for approximately $900 Million in false billing as part of the largest false claim takedown. The takedown focused on a broad range of providers including home health companies, physicians, physical and occupational therapy clinics, infusion clinics, mental health providers, DME suppliers, and compounding pharmacies. Of importance, the takedown focused on staying “a step ahead of emerging fraud trends, including drug diversion, and fraud involving compounded medications and hospice care.”