Integrating telehealth into compliance programs: Best practices for compliance professionals

Compliagent’s CEO, Nick Merkin, and Compliagent’s Regional Compliance Director, Erin Maclean, publish best practices primer in this month’s Compliance Today on integrating Telehealth into compliance programs.

Click here to read the full article:

https://compliancecosmos.org/integrating-telehealth-compliance-programs-best-practices-compliance-professionals?authkey=b2bcfaec403e463bcfa53d1c4c6e87011bd6cadfa224085b5699d7a3b9bead7b

OSHA Issues Updated Interim Enforcement Response Plan for COVID-19

The Updated Interim Enforcement Response Plan for COVID-19 provides instructions and guidance to Area Offices and compliance safety and health officers (CSHOs) for handling COVID-19-related complaints, referrals, and severe illness reports. On May 26, 2020, the previous memorandum on this topic will be rescinded, and the new Updated Interim Enforcement Response Plan will go into and remain in effect until further notice. This guidance is intended to be time-limited to the current COVID-19 public health emergency.

Of note, OSHA clarifies that cases of COVID-19 are not considered the equivalent of a common cold or seasonal flu. Employers are responsible for recording cases of COVID-19 if all of the following requirements are met: (1) The case is a confirmed case of COVID-19; (2) The case is work-related; and (3) The case involves one or more of the recording criteria such as receipt of medical treatment or days away from work. OSHA’s guidance emphasizes that employers must make reasonable efforts, based on the evidence available to the employer, to determine whether a confirmed case of COVID-19 would be considered work-related.

For more information regarding OSHA’s prioritization of COVID-19 inspection activities and compliance guidance, visit: https://www.osha.gov/memos/2020-05-19/updated-interim-enforcement-response-plan-coronavirus-disease-2019-covid-19

According to New Study, Preferred SNF Provider Networks Reduce Readmissions

Hospitals using a preferred network were able to reduce their readmission rates from skilled nursing facilities by 6.1 percentage points between 2009 and 2013, the study found. That's compared to a 1.6 percentage point drop in such readmissions to hospitals that did not have a network.

Read more here: 

http://content.healthaffairs.org/content/36/9/1591.abstract

Skilled Nursing Operator to pay $170,000 for Falsifying Records

Autumn Health Care of Zanesville and its owner, Steven Hitchens, both pleaded guilty to multiple charges in October following an investigation that revealed that the organization, including Hitchens and a number of facility managers had altered, forged, and, in some cases, destroyed records in order to maintain Medicare and Medicaid funding.

Among the charges against Hitchens and Autumn Health Care are: 

• providing unnecessary skilled therapy to Medicaid residents and billing Medicare Part B to pay for these unnecessary medical services; 

• falsely reporting unnecessary medical services in order to receive a higher reimbursement rate from the Ohio Department of Medicaid; 

• systematically falsifying resident records to defraud the Ohio Department of Health in an effort to make it appear that missed medical treatments were actually provided;

• destroying a record outlining an incident involving an ill resident who was found in a snow bank after escaping the facility and forging a new record that falsely described the incident in order to avoid a citation from the Ohio Department of Health. 

• forging a registered nurse's signature on resident assessments that were electronically sent to the Ohio Department of Health to bypass a requirement that a registered nurse certify the accuracy of the assessment.

The organization will be required to repay more than $52,000 to the Ohio Department of Medicaid, and an additional $40,000 in investigative costs to Attorney General Mike DeWine’s Office. Hitchens was ordered to serve three years of community control, 100 hours of community service, and is now under a period of federal exclusion from the Medicare and Medicaid programs as a result of his conviction.

Additionally, several of the organization’s managers and employees were all also sentenced to community controls and are under a period of federal exclusion from the Medicare and Medicaid programs. As a result, to their convictions, the Ohio State Board of Nursing permanently revoked the nursing licenses of all the nurses convicted of felonies.

For more information regarding this case visit: http://www.mcknights.com/news/provider-to-pay-nearly-170000-for-falsifying-destroying-records/article/630792/?DCMP=EMC-MCK_Weekly&spMailingID=16320456&spUserID=MTM0NDIzMDk1MDgwS0&spJobID=940972772&spReportId=OTQwOTcyNzcyS0

First HIPAA enforcement action for lack of timely breach notification settles for $475,000

On January 9, 2017, the OCR announced  a $475,000 HIPAA settlement based on the untimely reporting of a PHI breach.  Do you know what to do in the event of a breach? Read here for more...