The Louisiana Department of Health and Hospitals and the Louisiana Health Care Quality Forum have formed the Health Information Technology Advisory Council. Seventeen members from across the state were chosen to provide expertise to help develop health IT-related strategies in an effort to advance statewide health IT improvements. For more information go to: http://theadvocate.com/news/business/12878547-171/business-briefs-for-july-26.
Written by: Traci Thompson
The HHS’ Office of Inspector General released a report this past Monday indicating that a number of states providing services to Medicaid beneficiaries enrolled in managed care are not complying with the mandatory quarterly reporting requirements. In response to this study, the OIG recommended that the Center for Medicare and Medicaid Services use its authority to begin withholding federal funds from non-compliant states citing that the data is crucial to Medicaid oversight and the prevention of fraud and abuse. Although states struggle with capturing the level of quality data needed to complete the reporting requirements, CMS continues to make enforcement a priority. In response to the report, CMS indicated that it has already issued a notice of proposed rulemaking that would allow for the withholding of federal funds. For those states who lack the ability to capture the data whether through lack of technological infrastructure or other reasons, this latest policy does not bode well. For more information, go to: http://www.modernhealthcare.com/article/20150706/NEWS/150709966/not-all-states-reporting-required-medicaid-data-oig-says.
Written by: Traci S. Thompson
The Office of Inspector General of the United States Department of Health and Human Services is reviewing questionable billing practices related to Medicaid billing for pediatric dental services throughout Louisiana. A description of this state and national initiative can be found here. Continue reading
In recruiting doctors, hospitals must navigate several minefields which include Stark law and the Anti-Kickback Statute. Yet, a rarely considered issue when recruiting physicians is whether immigration laws have been violated. Generally, non-resident aliens who have completed a residency or fellowship training program in the United States must return to their home country for two years before they can work in the United States. Continue reading
The Office of Inspector General (OIG) issued a Proposed Rule on October 2, 2014 that would amend the safe harbors to the Anti-Kickback Statute and the civil monetary penalty (CMP) rules to add new safe harbors to codify statutory changes in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act, that would protect certain payment practices and business arrangements from criminal prosecution or civil sanctions under the Anti-Kickback Statute. The OIG also proposed to codify certain revisions to the definition of “remuneration,” added by the Balanced Budget Act (BBA) of 1997 and ACA and add a gainsharing CMP provision in the OIG’s regulations. Continue reading
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