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The top ways you can lose your nursing license

You have struggled through almost a decade of specialized schooling and training to get your nursing credentials. You love your job but realize that school did not prepare you for some of the hardships you now face.

Nursing is a noble career, and it is also one of the most closely watched. Rules and regulations abound, and many may seem to come with severe consequences. Losing your license would devastate your present and future. Keep an eye out for these top pitfalls to avoid getting mixed up in a situation that may result in a loss of your nursing license.

Company closes after Medicare stops covering diagnostic test

Coverage by medical insurance is important for more than just patients—it is also important for those who operate in the health care industry. Businesses that operate in this market often depend on payments from insurance companies to continue operations. Without payment for the services provided, the business may not receive the funds it needs to operate.

HHS makes headway on Medicare reimbursement appeal backlog

The Recovery Audit Contractor Program is one group that contracts with the government ot correct inaccurate Medicare payments. Those who disagree with the program’s findings can appeal the process. However, one of the biggest critiques of the appeals process is the length of time it takes to reach a resolution. As of February 2015, the appeals process took an average of 572 days.

Due to this excessive amount of time, the American Hospital Association (AHA) sued the program, stating it was required to abide by congressional mandated deadlines. The court ultimately ruled in favor of the AHA. The judge’s ruling included required backlog reductions.

TX city official sentenced to 2 years for health care fraud

The Southern District of Texas recently accused a Texas pharmacy owner of an elaborate health care fraud scheme. During the investigation, the prosecution gathered evidence to support allegations a city official was also involved in the scheme. The accusations were serious and included involvement in an alleged scheme to receive over $1.7 million in false payments from Blue Cross and Blue Shield of Texas.

Surgical errors and stress: New study finds a connection

Medical errors are responsible for hundreds of thousands of deaths in the United States every year. A portion of these mistakes happen within the operating room. This statistic inspired a master’s student from Columbia University’s Data Science Institute to search for a resolution.

His question: does stress within the operating room impact the surgical outcome? The answer: a resounding yes.  

Healthcare fraud in 2018: A sampling of major cases

The Department of Justice continued its crack down on healthcare fraud in 2018. This year included the $1 billion “Takedown Day.” On this day, police officers arrested and charged over 600 individuals for involvement in a $2 billion healthcare scheme. This is just one example of the government’s efforts to thwart healthcare fraud. Additional examples from throughout the year include:

Clinical labs: How does a new federal law impact your business?

Lawmakers often pass or change laws with good intentions. In some cases, those intentions may not translate in the real world. An attempt to thwart wrongdoing can result in an unnecessarily confining situation.

A recent change to the federal laws regarding payment to clinical laboratories may be one such case.

Will the HHS find alternative pay an Anti-Kickback violation?

The government is working to transform our healthcare system into one that pays for value. The Health and Human Services Department (HHS) recognizes that care coordination is an important tool to meeting this goal. However, the government has also recognized physicians and other medical professionals abused this system with the use of kickbacks solely intended for financial gain. To thwart such abuse, the government had previously passed Anti-Kickback laws.

Although these laws have reduced abuse, they have also made it difficult for physicians and other medical professionals to coordinate patient care. The government has recognized this issue and is reevaluating the rules and regulations that are currently in place.

Did a TX hospital commit a crime by failing to release patients?

Psychiatric facilities must operate while maintaining a difficult balance: provide the care patients need while not discharging them at a time they could injure themselves or others. A failure to navigate this balance wisely can result in allegations of criminal wrongdoing.

Texas officials have recently accused a local psychiatric facility of such wrongdoing. According to the indictment, the facility failed to aid patients in creating discharge documents and thus held the patients against their will. This resulted in allegations the facility violated Texas state law.

Nurses in Texas: Watch out for these two work related concerns

Those who choose to enter the profession of nursing must prepare to navigate a number of issues. Two examples currently spotlighted by the media include the various scopes of practice and problems with patient violence.

Scope of practice: Different in every state

Every state has its own laws that govern the field of nursing. The Texas Legislature passes the regulations that govern the field in the state, known as the Nursing Practice Act. Nurses that fail to abide by these regulations could find themselves needing to defend their license.

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