In the past, most industry discussions about Medicare audits have been focused towards larger providers such as hospitals. However; smaller providers beware-- it looks as if Skilled Nursing Facilities (SNFs) are just as susceptible to being audited by the Recovery Audit Contractors (RACs).

Each RAC has set priorities for every specific region, and recently they have been focusing on SNFs in regions A, C, and D. Specifically....

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Although I do not have a crystal ball, you do not have to be a fortune teller to predict that 2012 is going to be both an exciting and daunting year for the healthcare industry and its constituents. With new technologies paving the way for more coordinated cost-effective care and strict deadlines and regulations put in place there are clear trends we are likely to see in the upcoming year. We can expect to see the following projects and movements in 2012.... [More]

As end of the year countdowns fill the radio, TV and internet airwaves we thought we would jump on the bandwagon and recap this year’s top healthcare industry trends. 2011 brought many changes to the healthcare landscape including the introduction of many business automating technologies and stricter regulations that place physical and financial restraints on providers. Here is a look at the top three trends of 2011.... [More]

What is cloud computing?

Cloud computing can be defined as shared resources, software, and information that can be provided to computers over the Internet using a web browser. The cloud computing model enables more convenient and on-demand access to information and data by the user.... [More]

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is on the hunt for healthcare providers who have breached privacy and security rules. Any violation of HIPAA laws can mean non-compliance and can warrant an OCR investigation. Anything from denying patients access to their electronic health record (EHR), to accidentally exposing protected health information (PHI) can get your facility a slap on the wrist in the form of a hefty fine. Recently, the OCR fined Massachusetts General $1 million and Cignet Health $4.3 million for these simple mistakes.

According to HHS’s Health Information Security Rule Trends in Enforcement report 243 security complaints were made and reviewed in 2010, up more than 50% from previous years, and over the past 5 years 150 cases resulted in corrective action with fines ranging from $100 to over $4 million.... [More]

 

The dawn of the digital age brings new struggles for healthcare providers. As access to confidential patient information expands through the use of electronic health records (EHR), worries about patient privacy and risk of data breaches increase—and rightfully so. Since September 2009, nearly 300 breaches have been reported to The US Department of Health and Human Services Office for Civil Rights, affecting the care of over 11 million individuals on varying levels.

With all of the benefits that an EHR can provide, it also has its downfalls-- electronic data infringements occur 3 times more frequently than paper based breaches and on average cost up to 10 times more in damages. That being said, old privacy and security controls no longer suffice in today’s data-sharing world.

A recent nationwide study done by PwC of over 600 hospital executives found that.... [More]

Personal Health Information (PHI) has seemed to be the buzz word within the healthcare industry over the past year. As providers put Electronic Health Records into place and patient information becomes digital, data security seems to be the proverbial elephant in the room. Where does sensitive patient information get stored, who has access to it, and how it is being used?

A 2009 survey done by the National Research Council found that electronic health record systems were often poorly designed, and could "increase the chance of error, add to rather than reduce work flow, and compound the frustrations of doing the required tasks"....

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Over the past few years The Centers for Medicare and Medicaid Services (CMS) has implemented a program to collect improper Medicare payments through Recovery Audit Contractors (RACs), waging a war against unprepared healthcare providers. In result, facilities across the country have had to gear-up for battle as the RAC soldiers continue their hunt for payment-perpetrators.

A nationwide survey of 200 healthcare providers done by IVANS found that 73% of hospitals agree that the RAC Program helps to reduce fraud and errors in the industry. However, more than 60% do not think the audit process is fair.... [More]