The pandemic fueled change in our family lives, our working lives and even the marketplace as a whole. The pandemic changed every marketplace within our communities, from retail to healthcare. One of the most visible changes within the healthcare marketplace is the...
Month: April 2021
3 most common HIPAA inaccuracies, debunked
There are many misconceptions surrounding the Health Insurance Portability and Accountability Act (HIPAA). Some of these are fairly harmless, others can cause big problems. Medical professionals like nurses are wise to understand this law, as a failure to properly...
Feds ask for $200M in overpayments from Medicare Advantage group
In what the Health and Human Services Office of Inspector General is calling the largest audit penalty every imposed on a Medicare Advantage company, the feds have recently completed and an audit and are calling on the company to pay over $200 million back in Medicare...
Can a nurse get fired for refusing to get the COVID-19 vaccine?
We are going through difficult times. The pandemic continues and many throughout the country are getting the vaccine to help reduce the risk of contracting and potentially spreading COVID-19. The question of whether or not a nurse or other medical professional could...
What should I know about overpayment recovery?
An overpayment recovery request from Medicare or a private carrier essentially means the payer is stating that they want their money back. They already sent your group payment for a claim, but now they have decided the payment was either too much or unwarranted. It is...
How do regulations apply when pharmacies use robots?
Pharmacists are, essentially, medication managers. These medical professionals spend years studying and training to provide patients with guidance and information on various medications. In some cases, they may fill prescriptions and discuss benefits and potential...
What happens when a nurse is accused of a crime?
There are few professions the public holds in a higher regard than that of a nurse. These professionals spend years studying, training, and preparing for their chosen profession. It is unfortunate that a single error in judgement can put this all at risk. There are...
Anatomy of an HHS audit
The United States Department of Health and Human Services (HHS) recently announced updates to its Phase 2 Health Insurance Portability and Accountability Act (HIPAA) Audit Program. These audits aim to check for an entity’s compliance with certain requirements. The...
How do I stay current with my CMEs and avoid burnout?
There is no question that medical professionals faced enormous pressure this past year. From determining the best types of PPE to reduce the risk of exposure to COVID-19, keeping family and loved ones safe while still helping patients receive the care they need — it...
Feds demand millions in Medicare overpayment after audit
The United States Department of Health and Human Services (HHS) Office of Inspector General recently released its findings from an audit of an HCA Healthcare owned facility operating out of Las Vegas. According to their findings, the facility owes the feds millions....