Transcript Audits - Management Performance Associates

Implementing and Maintaining
an Effective Compliance Program
Elizabeth Parker, JD
Andrew Buffenbarger, MBA, LNHA
Management Performance Associates
Missouri Health Care Association
August 27, 2013
Agenda
1.
2.
3.
4.
5.
Compliance: Why We Should Care, Now
Building an Effective Compliance Program
Auditing and Monitoring Workshop
Building a Strong Compliance Officer
Current Issues and Risk Areas
Compliance: Why We Should
Care, Now
Elizabeth Parker, JD
Management Performance Associates
Planning Questions
1. Who will be in charge of implementing
and overseeing your compliance
program?
2. How much time have you committed to
implement your compliance program?
3. How much will you budget for your
compliance program?
Compliance Is Mandatory
• March 23, 2013
• Medicare/Medicaid Condition of Participation
Patient Protection and Affordable Care Act
Stark/ SelfReferrals
False Claims
Medicare &
Medicaid
requirements
Kickbacks
OIG
Screening
HIPAA
Accurate
billing and cost
reporting
Resident
Rights
Nursing Home
Administrator
Quality of
Care
Federal Health Care regulations are a lot to juggle
HIPAA
• Privacy Rule
• Security Rule
• Breach Notification Rule
Penalties: HIPAA
• Civil penalties: up to $50,000 per violation
($1.5 Million annual maximum per type of
violation)
• Criminal penalties: up to $250,000 and 10
years imprisonment
OIG Screening
• Medicare and Medicaid will not pay for
services performed by people whom the
government has excluded from participating
in Medicare and Medicaid.
Kickbacks
Anti-Kickback Statute
• The Anti-Kickback Statute prohibits giving or
receiving anything of value to induce or
reward Medicare or Medicaid referrals.
Kickback Penalties
• Criminal penalties: $25,000; 5 years in prison
• Civil penalties: $50,000 penalty, civil
assessment of up to 3 times the kickback,
exclusion from federal health care programs,
all False Claims Act penalties
Examples of Illegal Kickbacks
• A hospice provides free goods or goods below fair
market value to a SNF to induce the SNF to refer
patients to the hospice
• A DME company provides free devices to doctors who
prescribe and order DME from the DME company
• An imaging center and medical center agree that the
medical center will send its patients to the imaging
center—and they will split the profits.
• A home health company pays a rehab company cash
for every patient rehab refers to the home health co.
Rehab Co.
Under investigation by the US DOJ for allegedly
paying illegal kickbacks:
• One time fee of $600,000 to a SNF chain to
get the rehab contract
• Billed SNF 70% of the Medicare rate and split
the remaining 30% with the SNF
Stark/Physician
Referrals
Stark/Self-Referrals
• The Stark Law prohibits referrals between
physicians and health care entities that have
certain financial relationships with physicians,
such as an ownership or investment interest,
or a compensation arrangement.
Penalties: Stark Law
• Repayment; $15,000 Civil Monetary Penalty
per service, 3 times amount claimed,
exclusion, False Claims Act liability
Physical Therapy Co
PT Co. and a physical therapist paid $62,400 for
accepting patients with a physicians order for
physical therapy written by therapists spouse.
A Missouri
Health System
A hospital paid $9.3 Million after it self-reported
arrangements with 70 doctors, over a decade,
with illegal financial incentives to refer patients
to the hospital. Doctors received incentive pay
based on the Medicare revenue generated from
their referrals to the hospital.
False Claims
False Claims
• The False Claims Act prohibits submitting false
or fraudulent claims to the government.
• Penalties: up to 3 times the claim amount,
plus $11,000 per claim
Rehab Co.
Paid $1.5 Million for submitting claims to
Medicare and Medicaid for services provided by
an unlicensed speech therapist.
Nursing Home Co.
Paid $953,375 for providing services that were
unnecessary, and submitting claims to Medicare.
For example, occupational therapy was provided
to elderly Alzheimer’s Syndrome patients who
could never expect to return to the workforce.
Nursing Home Chain
•Charged with violating the False Claims Act by
encouraging therapists to bill higher amounts
and do more expensive therapy—even if
patients didn’t need therapy or could be
harmed by it.
•Chain billed nearly 68% of its Medicare rehab
days at RUH. The national level is 35%.
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Billing and cost reporting
Medicare/Medicaid requirements
Resident Rights
Quality of Care
Civil Monetary Penalties
•up to $50,000 per violation
Guess the Penalty
A hospital discovered that it had made billing
errors for the drug Lupron, which resulted in
overpayments by Medicare—and did not report
the error or repay Medicare.
Guess the Penalty
The operator of SNFs in Atlanta submitted
claims for inadequate and worthless wound care
services.
Guess the Penalty
A university medical center submitted false
claims:
- Double billed Medicare for procedures
- Billed for high reimbursement radiation oncology
services when a different, less expensive service
should have been billed
- Billed for procedures without supporting
documentation in the medical record
- Improperly billed for treatment without
corroborating physician supervision
Guess the Penalty
A pharmacy employed a pharmacist who had
been excluded from participating in
Medicare/Medicaid.
Guess the Penalty
A hospital entered a settlement in a
whistleblower suit to resolve allegations that
one of its physicians signed off on vascular tests
(billed to Medicare) without reading the tests.
Guess the Penalty
Los Angeles area hospitals paid “recruiters” to
bring homeless Medicare and Medicaid patients
from Skid Row to the hospitals, for treatment
that was medically unnecessary.
Guess the Penalty
Jury assessed penalties against former owner of
a nursing facility for submitting false or
fraudulent claims for worthless services
Guess the Penalty
Medical equipment company submitted claims
for Medicare patients who no longer qualified
for the equipment, including patients who had
died or were no longer using the equipment.
Guess the Penalty
• A hospital limited treatments at its outpatient
cardiology testing location to cardiologists
who referred patients to the hospital.
• Cardiologists who referred a certain amount
of revenue to the hospital were rewarded with
more opportunities to treat patients at the
outpatient location.
Sometimes Money Isnt Enough
• SNF DON sentenced to 3 years in prison on a
felony count of elder abuse for ordering
administration of psychotropic meds to 23
patients
• CEO pled no contest to a felony count of
conspiracy to commit an act injurious to the
public, for her failure to adequately supervise
the DON
Sometimes Money Isn’t Enough
• (Former) RN sentenced to 111 months in
prison
• Helped admit ineligible patients to partial
hospitalization program for mental illness
• Fabricated medical records to support false
and fraudulent claims
• Laundered health care fraud proceeds
Most of Us Don’t Look Good in Orange
Don’t Be the Low Hanging Fruit
Enforcement Is Up
OIG enforcement activity
2011 Result
2012 Result
Recoveries from audits and investigations
$5.2 Billion
$6.9 Billion
Individuals/entities excluded from Federal
health care programs
2662
3131
Criminal actions brought against
individuals/entities
723
778
Civil actions brought (false claims lawsuits,
civil monetary penalty settlements, provider
self-disclosures)
382
367
ABC Nursing Home
• Paid $675,000 for submitting claims for
therapy (provided by Therapy Co) that did not
match the residents’ needs.
• Home is suing Therapy Co for negligence and
breach of contract.
• We dont know if Therapy Co will face
government penalties.
Nursing home CIA
• 5 years
• Establish and maintain Compliance Program
• Independent review of:
• MDS
• Therapy systems assessment
• Unallowable cost review
• Validation review by the OIG
Nursing Home CIA
• Must report to OIG:
• All government investigations
• Substantial overpayments
• Probably violations of the law
• Employment of/contracts with excluded providers
• Bankruptcy
• Failure to provide quality care
• Implementation report
• Annual reports
Building an Effective Compliance
Program
What is a Compliance Program?
• A system of policies and procedures,
monitoring and auditing tools, communication
and reporting methods, enforcement, and
leadership, designed to follow federal and
state laws and federal healthcare program
requirements.
Why Do We Need Compliance?
• Comply with health care laws and program
requirements
• Ensure excellent quality and accurate billing
• Minimize risk of government penalties
• Identify and correct compliance problems as
soon as possible
Is Your Plan Effective?
• Criminal sanctions may be mitigated by a
compliance program, but only if that program
is effective.
• Most SNFs lack the policies & procedures, staff
training, audit functions, and regulatory
updates to keep their compliance programs
effective.
Required Compliance Program
Components
• Written Policies & Procedures, Code of
Conduct
• Compliance Officer & Compliance Committee
• Training and Education
• Effective Lines of Communication
• Enforcement of Standards
• Responding Promptly to Detected Offenses
and Taking Corrective Action
• Auditing and Monitoring
Risk Areas
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Quality of Care
Resident Rights
Billing & Cost Reporting
Employee Screening
Kickbacks, Inducements and Self-Referrals
Submission of Accurate Claims
HIPAA Privacy and Security
Record Creation and Retention
Anti-Supplementation
Medicare Part D
Where Do I Start?
Identify risk with a baseline audit:
•Identify risk areas
•Identify strengths and weaknesses
•Seek input from all departments
•Always be on the lookout for “new” risks
Periodic Audits
…keep your compliance program effective
Annual Review
• Annual Review of the overall effectiveness of
the compliance program
Benefits of Compliance
• Minimize financial loss with reduced sanctions
and penalties
• Improve quality of care and enhance your
reputation
• Lower exposure to liability
• Reduce whistleblowing
• Minimize repayments
53
Auditing and Monitoring
Workshop
Andrew Buffenbarger, MBA, LNHA
Management Performance Associates
Missouri Health Care Association
August 27, 2013
Auditing
Employee Screening for OIG Exclusion
• Does your pre-employment screening meet
the requirement?
• Do you screen contractors?
• Do you screen volunteers?
• Do you screen directors, officers, and/or board
members?
• Do you screen before hire and monthly?
Auditing
Employee Screening for OIG Exclusion
Your employee screening P&P should require:
- OIG exclusion, GSA suspension/debarment,
and state exclusion list screens for new
employees, volunteers, directors and vendors,
plus periodic re-checks
Auditing
Employee Screening for OIG Exclusion
• Task breakdown
Category
OIG
exclusion
GSA suspension
State
(Medicaid)exclusion
Criminal
background
Employee, Director/Officer
X
X
X
X
Contractor
X
X
X
Require by
contract
Volunteer
X
Auditing
Consequences
• The OIG will assess penalties to SNFs that
employ or contract with an excluded provider.
– Re-pay Medicare and/or Medicaid
reimbursement associated with the specific
employee or contractor
– Assign civil money penalties including fines
and treble damages
– Potentially become excluded from
participation in state and federal health
care programs
Auditing
Employee Screening for OIG Exclusion
• The OIG is looking for individuals that pose a
risk to the beneficiaries of Medicare,
Medicaid, and all other Federal health care
programs.
• Exclusions occur as a result of fraud and abuse
convictions, program related convictions,
licensure action, and others.
Auditing
Employee Screening for OIG Exclusion
How do we audit this?
See if P&P require these screens
- Interview staff responsible for hiring to
determine if they understand these P&P, and
if they are followed
- Check employee/vendor/volunteer files to
verify OIG exclusion check was documented
- Review contracts to ensure vendors conduct
similar screens
Auditing
Therapy
• Therapy (part A & B) is a constant focal point
for investigators.
• Medicare expenditures in SNFs have more
than doubled in the last decade (OIG work
plan, 2013)
• An OIG investigation will certainly include a
review of your therapy documentation
Auditing
Therapy
• Regular audits are essential to minimizing
your exposure to false claims
• Start with a therapy checklist, assign the audit
process to someone outside of the therapy
department, and report results to the
Compliance Officer and Committee
Quality Assurance Program
• Quality assurance programs are your best tool
to drive strong quality outcomes and avoid
penalties.
• A nursing home paid $305,072 and was
required to hire a full-time physician or NP
after it was found to have sub-standard
pressure ulcer treatment and prevention,
incontinence care, pain management,
nutrition, weight monitoring, infection
control, and diabetic care.
CMS Guidance for QA
• CMS released guidance to SNFs regarding the
development of a QA program.
• Quality Assessment and Performance
Improvement (QAPI)
• Five elements
QA Program Setup
Five Elements
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Design and Scope
Governance and Leadership
Feedback, Data Systems, and Monitoring
Performance Improvement Projects
Systematic Analysis and Systemic Action
QAPI
Design and Scope
• Your Quality Assurance program should focus
on these key elements
– Clinical care
– Quality of life
– Resident choice
– Care transitions
QAPI
Governance and Leadership
• Executive leadership
– Committee members should have the authority to
direct work processes and take corrective action
• Setting facility priorities – establish quality
indicators
• Training, equipment, allocating staff time
QAPI
Feedback, Data Systems and Monitoring
• Systems to monitor care
• Auditing tools and methods
• Collect data for analysis
QAPI
Performance Improvement Projects (PIPs)
• Concentrated analysis
• Review areas of concern
• Well documented, thorough investigation
QAPI
Systematic Analysis and Systemic Action
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Root cause, or similar, analysis
Repeatable, policy driven solutions
Documented approach
Full disclosure to the Committee
Quality Assurance Approach Example
Quality
Indicator
Incidence of
new fractures
Result
Target
Variance from
target
Variance
report
1
0
1
Yes
Event
Resident is found on the
floor in her room with a
fractured hip at 0200.
Resident cannot report.
Variance Reporting
• Assemble facts in a storyline.
– Use interviews to determine what may have
caused the resident to be on the floor.
• Interview the roommate if applicable.
• Interview the night shift staff using the
“who, what, where, when, and how?”
approach for an initial understanding of
the event.
Event Review – Initial
Understanding
R1 is found on the floor in her
room with fractured hip at 0200.
Resident cannot report.
Roommate R2 reports R1 was
assisted to bed by E1 using a sitto-stand lift. R1 was not assisted
to the restroom prior to bed.
R2 reports R1 was restless and
tried to get out of bed without
help.
E2 reports that R1 had
noticeably outward rotation to
her hip. 911 called, physician,
family, DON & Admin notified.
R2 reports E1 entered the room
in less than one minute, then
called from the doorway for the
nurse E2. E2 entered the room
immediately thereafter.
R2 reports R1 tried to stand from
bed and immediately fell to the
floor. R2 turned on her call light
to summon staff.
E2 reports EMTs took R1 to the
hospital with probable Fx hip.
Hospital confirmed Fx.
Analysis
• Where are the gaps in the story?
• Who will you interview?
• What will you ask?
• Drill down for details
Final Step
• Variance reporting
– Report your summary of findings and action
plan to the QA Committee.
– Use the QA meeting to track the progress of
your action plan.
– Hold people accountable for results. We’re
protecting the frail elderly – we do not let
this go.
Quality Assurance Program
• Good QA programs are comprehensive and
fluid.
– Strong, consistent committee
– Standard quality indicators
– Performance expectations
– Variance analysis
– Variable quality indicators to address
current issues
Quality Assurance Program
• QA is a key communication tool. What do you
want to share with your staff?
Program Integration
• Use QA to monitor your compliance program
efforts
– P&P reviews
– Complaint log/action
– Staff training
– Billing audit results
Auditing
Summary
• Conduct pre-employment screens using the
OIG exclusion list, GSA suspension/debarment
list, State exclusion list (if applicable), and
criminal background check
• Repeat screens monthly
• Screen contractors/vendors and require
similar screens in contract language
• Conduct criminal background checks on
volunteers
Auditing
Summary
• Quality assurance program
– Five elements
– Proactive, reactive, effective
– Therapy audits
• Auditing
– Employee screening and therapy are only
two of the many audits that should be
performed.
Building a Strong Compliance
Officer
Andrew Buffenbarger, MBA, LNHA
Management Performance Associates
Missouri Health Care Association
August 27, 2013
What is a Compliance Officer
• First, let’s hear from you about the role of a
compliance officer.
Compliance Officer 101
Continued
• Developing a position description will guide
your selection
• Essential duties
– Oversee and monitor the implementation
of a corporate compliance program
– Help the organization, through policies and
procedures, auditing, and training, minimize
the risk of fraud and abuse
Compliance Officer 101
Continued
• Manage facility audits, collect data, develop
responsive action plans, report to the
Compliance Committee
• Receive, log, and respond to compliance
hotline reports
• Facilitate or conduct compliance training for
directors, officers, and employees
Compliance Officer 101
Continued
• Manage employee, officer, contractor, and
volunteer screening
• Oversee HIPAA compliance activity
• Participate in the Quality Assurance program
• Conduct annual compliance program review
and update
• Ensure contractors are aware of your
compliance program and resident rights
Compliance Officer Selection
• What qualifications would you look for when
selecting a Compliance Officer?
Compliance Officer Selection
Continued
• Suggested background and experience
– Extensive experience in regulatory compliance in a
skilled nursing facility or similar environment
– Clinical experience is helpful
– Experience reporting to a Board or senior
leadership
– Data system creation and use, auditing, and strong
analytical skills
– Education across multiple organizational levels
Compliance Officer Selection
continued
• Highly organized
• Advanced investigative skills and experience with
root cause analysis
• Experience with quality assurance programs
including development and implementation
• Understanding of the billing systems applicable to
your organization
• General understanding of the inner workings of
all departments applicable to your organization
General Information
• A CO can hold another position within the
organization at the same time, i.e., staff
development coordinator, quality assurance
nurse
• During interview and selection, consider that
this person will have to interact with Board
members, CNAs, housekeepers, department
leaders, contractors, volunteers, and
regulators
CO Integration
• The CO will be highly visible. Acquaint him/her with everyone
in the organization
• Walk through key focus areas – as documented in the
Corporate Compliance Program
– Billing
– QA
– Care delivery
– Dining and culture
– Software systems
– Employee screening and on-boarding
– P&P
Getting Started
Seven Steps
• You’ve selected, hired, and oriented the CO.
Now what?
• Here are the seven steps to creating a
compliance program
Getting Started
Step 1
• Create a job description and an organizational
policy for the Officer and Committee
• Appoint a Compliance Officer with the right
combination of education and experience
• Appoint a Compliance Committee
Getting Started
Step 2
• Conduct a baseline assessment of your
current compliance level
– Training and education
– Lines of communication
– Enforcement of standards
– Monitoring and auditing
– Response to detected offenses/corrective
action
Getting Started
Step 2 continued
• Assess your current policies and procedures in
the following risk areas:
– Quality of care
– Resident rights and safety
– Employee screening
– Billing and claims submission
– Cost reporting
– Kickbacks, inducements, self referrals
Getting Started
Step 2 continued
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Creation and retention of records
HIPAA
Anti-supplementation
Medicare D plan selection
Getting Started
Step 3
• Develop plan documents
– Compliance program document
– Code of conduct
– P&P addressing each risk area
Getting Started
Step 4
• Train and educate
– Provide compliance training to all
employees, officers, directors, owners upon
hire and annually
– Create a training schedule for each risk area
Getting Started
Step 5
• Audit and Monitor
– Develop audit tools for each risk area
– Schedule audits throughout the year
– Assign responsibility for audits
– Develop a reporting mechanism for audit
results
Getting Started
Step 6
• Review annually
– Celebrate progress
– Identify areas where you can advance
compliance even further
Getting Started
Step 7
• Stay current
– Monitor and incorporate updates into your
Compliance Program
• New regulations
• OIG updates
• Recent enforcement actions
Quick Poll
• Who has a CO in place?
• Do they hold another position within the
facility? What is it?
• What do they do?
• Is there anything else you think they should
do?
• What advice would you give others about
recruiting, selecting, hiring, and employing a
CO?
Use the Momentum
• Your Compliance Officer is the key to a
successful program.
• Use this discussion as the catalyst for the
development of a fully operational
Compliance Program led by an outstanding
Compliance Officer!
Current Issues and Risk Areas
Elizabeth Parker, JD
Management Performance Associates
Missouri Health Care Association
August 27, 2013
OIG Work Plan 2013
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Waste (unnecessary services)
Patient safety
Quality of care
Fraud and abuse
Waste (Unnecessary Services)
• Claims processing errors – Medicare payments
for Part B claims with G modifiers
• Payments for services after beneficiaries’
death
Patient Safety
• Adverse events in post-acute care for
Medicare beneficiaries
• Use of atypical antipsychotic drugs
• Communicable disease care
Quality of Care
• Medicare requirements for quality of care
• Medicaid waivers – adult day health care
services
Fraud and Abuse
• Hospices – marketing practices and financial
relationships with SNFs
• Payments for alien beneficiaries unlawfully
present in the U.S. on the dates of services
OIG Finds 25% of SNF Claims Faulty
• 20.3%: Claims with an inaccurate RUG
(upcoded).
• 2.5%: Claims with an inaccurate RUG
(downcoded)
• 2.1%: Claims that did not meet Medicare
coverage requirements
OIG finds 25% of SNF claims faulty
• Increase and expand review of SNF claims
• Identify SNFs that are billing for higher paying
RUGs
• Monitor compliance with new therapy
assessments
• Change the method for determining how
much therapy is needed
• Improve the accuracy of MDS items
• Follow up on the SNFs that billed in error
Increased Scrutiny of Therapy
• Fairfax Nursing Center
• $700,000
• Knowingly submitting claims for nonreimbursable therapy
OIG finds 25% of SNF claims faulty
• How can we prepare for increased review of
SNF claims?
HIPAA: Old Penalties (Pre 2009)
• $100 maximum per violation
• $25,000 yearly limit for identical violations
• $0 if unaware of the violation
HIPAA: Increased Civil Penalties
• Did not know/would not have known
At least $100, max. $50,000 per violation
• Reasonable cause but not willful neglect
At least $1,000, max. $50,000 per violation
• Willful neglect, corrected in 30 days
At least $10,000, max. $50,000 per violation
• Willful neglect, not corrected 30 days
At least $50,000 per violation
* For identical violations in a calendar year, $1.5M max
HIPAA: Criminal Penalties
• Up to $250,000
• Up to 10 years imprisonment
HIPAA: Increased Enforcement
• Health System, $4.3 Million
• Hospital, $1 Million
• Health System, $865,000
• Former Employee, 4 months in jail
When Penalties and Jail Time
Aren’t Enough…
• Health System
• Face sheets and unencrypted digital files of
patient information were stolen
• Sued for $50 million
PHI
• The Privacy and Security Rules protect PHI:
information than can identify a patient and
relates to the patient’s health condition,
treatment, and payment for treatment.
• PHI can be used for treatment, payment, and
health care operations. For any other purpose,
the use must have a patient authorization, or
be permitted by written HIPAA policies and
procedures.
Need To Know Basis
• HIPAA keeps us on a “need to know basis.” If
you don’t need to access PHI to do your
specific job or provide patient care, don’t
access it.
• When you need to share PHI, keep others on a
need to know basis as well—only share the
minimum necessary PHI to accomplish the
task.
Patient Rights
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Right to receive Notice of Privacy Practices
Right to access their own PHI
Right to request to amend their PHI
Right to request confidential communication
(e.g. cell phone or office number only)
• Right to request an accounting of disclosures
of their PHI
• Right to give permission to discuss PHI with
family & friends
Protecting PHI
• Change passwords frequently, never share
• Lock laptops and other devices
• Log off when you leave your desk; use
automatic log-off
• Don’t download software or install hardware
without approval
• Avoid sending PHI over e-mail. When e-mail is
required, follow policy.
Protecting PHI
• Avoid discussing patients in public spaces or
areas where you can be overheard.
• Keep patient files and other documents with
PHI on them locked away, or placed upside
down so they can’t be seen.
• Lock your computer screen. Position your
monitor so people cannot see your screen
when they walk by
• Verify identity of anyone requesting PHI
Protecting PHI
• Do not leave PHI on printers, fax machines,
copiers
• Do not leave PHI on your workstation
• After using PHI, destroy copies using the shred
bin
• Only remove PHI from work if absolutely
necessary. Never leave PHI unattended or in
your car
• Call IT if your smart phone is lost or stolen
• Do not store passwords on your PDA
Breach Notification
• When PHI is breached (stolen, lost, hacked,
inadvertently given to the wrong party, etc.),
must notify the patient(s) involved, the
government, and sometimes the media.
• If you learn of a potential breach, immediately
notify your privacy officer
HIPAA: Penalties for Breaches
• August 273, 2012: First settlement involving
the HITECH Breach Notification Rule
• Blue Cross Blue Shield of TN paid $1.5M
HIPAA: Top 5 Violations
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Impermissible uses and disclosures of PHI
Lack of safeguards of PHI
Lack of patient access to their PHI
Uses or disclosures of more than the
minimum necessary PHI
• Lack of administrative safeguards of ePHI
HIPAA: Audits
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Required by HITECH
150 audits by the end of this year
Must provide P&P within 10 days
Site visit
HIPAA: To Do
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Privacy Rule policies, procedures, forms
Security Rule risk assessment, P&P
Business Associate Agreements
Breach notification P&P, forms
Training
http://www.hhs.gov/ocr/privacy/index.html
HIPAA: Social Media
• Do you trust your employees?
HIPAA: Social Media
• “It’s just Facebook,” “I’ll post what I want”
• Photos of residents are PHI
• Patient name not required
HIPAA: Social Media
• Educate your employees about social media
use
HIPAA: Portable Devices
• E.g. smartphones, tablets, laptops
• Settlement: $1.5 Million
• www.healthit.gov
Stay Informed
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http://oig.hhs.gov
LeadingAge Hotline
CMS Survey & Certification
http://www.hhs.gov/news/email/index.html
MPA Compliance Updates
Elizabeth Parker, JD, General Counsel & Compliance Manager
Andrew Buffenbarger, MBA, LNHA, Managing Associate
www.healthcareperformance.com
MPA works with healthcare providers who want to ensure they meet
the strict and ever-changing Federal criteria for compliance
programs. We are uniquely qualified to manage every stage of
compliance program development, implementation, and ongoing
management.
This presentation is copyrighted, © 2013 Management Performance Associates
Management Performance Associates is not a law firm and does not provide legal advice. If
you have any questions about how compliance applies to your organization, please contact
your attorney.