PRESS RELEASE: Compliance University Rollout


September 9, 2011

Medical Auditing Solutions LLC is excited to announce the release of our new service called “Compliance University.”  The Compliance University focuses on the healthcare regulatory compliance annual training requirements for all employees.  HIPAA requires annual privacy and security training for all employees (2003 & 2010) respectively.  Compliance (billing, contracts, and relationships) is required as part of the Healthcare Reform Act and the Patient Protection Accountability and Affordable Care Act due 2013.  This training is only one aspect of an effect Compliance program.  Privacy and Security is primarily monitored, audited and investigated by HHS and Office of Civil Rights.  Compliance is primarily monitored, audited, and investigated by CMS, OIG, HHS, FBI.  The monitoring, auditing, and investigation may start in other federal and state government areas.

All programs are general in nature and meant for any type of health care providers.  They are between 40 minutes and 1 hour.  Each program is followed by a test of comprehension, an evaluation that is required to receive the completion certificate.  The Compliance University will provide the company with status, completion, grade reports.  We have additional programs to be released within the next few weeks as well to complete the set.  The programs contain examples and explanation for various health care industries so the knowledge obtained can be applied in any setting.

We look forward to helping you with your compliance program training as well as other areas of development and tracking that you may need to complete.  Check out our website at www.MedicalAuditingSolutions.com and Compliance University.  Mention this press release “PRESS” and receive 10% discount.

FBI-Federal Bureau of Investigation

HHS-Health and Human Services

OCR-Office of Civil Rights

OIG-Office of Inspector General

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Compliance Program Development Required by 2013


Have you started developing your compliance program yet?  Do you have a compliance program that is incomplete or not as active as it should be?

The Health Care Reform Act and the Patient Protection and Affordable Care Act require a compliance program be implemented by 2013 for all health care providers and dental providers that bill Medicare and Medicaid or any federal and state funded programs. The OIG (Office of Inspector General) has had suggested compliance program guidance for several years for hospital, physicians, DME and home health. I would recommend health care providers start planning by using these OIG guidelines because it will take at least 9 months to have a program implemented completely. A compliance program will also help your business run more efficiently if the program is managed correctly.
Compliance programs focuses business operations & management, contracts, relationships, billing, and the laws associated with each. Two key components to ensure success for the program is executive support and employee participation.   A compliance program  is more than policies.
The elements of a compliance program include:
1. Compliance Officer, which may hold several positions in smaller agencies.
2. Compliance Committee, best to have managers or supervisors from various departments to be a solid advisory committee.
3. Standard of Conduct covers various topics from Stark Law, Antikickback statute, Company funds, Investigations & legal matters, billing expectations, complaint reporting, and much more.
4. Policies and Procedures expand some sections of the standards of conduct such as the billing section.
5. Training of at least 5 hours per year, in addition to the training for privacy and security annually.
6. Auditing and Monitoring help ensure the risk areas for the company and identified by the OIG stay within the regulations and coverage criteria, prevents fraud and abuse or at least early detection, and training to prevent the repeat of erroneous actions.
7. Hotline for reporting,even if it is a local phone number for small companies with 1 to 2 locations. Complaint reporting should not be limited to a hotline.  Complaints should be allowed by email, mail, and fax as well. You need a hotline poster, but it does not have to be elaborate or expensive.
If you can you help with your compliance program, we have extensive experience in health care compliance program development and management.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Speaking Engagements 2011


March 1, 2011
California Association of Medical Providers & Suppliers

Angela Miller speaking for Zirmed Financial Workout Webinar Series

April 20, 2011

VGM’s Heartland Conference

June 8 – 9, 2011

Texas Osteopathic Medical Association

June 17, 2011  10am-noon

Medtrade Fall 2011

October 26 & 27

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KY Medical Equipment Suppliers Associate (KYMESA)

November 9, 2011 – Compliance Program Implementation

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PaychexsIrving Texas office contact Christina Rossini to register.

December 6, 2011 – Compliance Program Requirements

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Medtrade Spring 2012

April 10-12, 2012

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American Association of Osteopathic Executives

May 20-22, 2012

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Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Compliance Programs Required 3/25/2013


Well, we thought with Health Care Reform Act of 2010 that providers had 3 years from the signature date to have a plan implemented. With the final provisions of the Patient Protection Affordable Care Act, you have until 3/25/2013…less than 2 months to have a compliance plan in place.   They make reference to the 7 element compliance program currently recommended as a basis for the program structure. The final rule has language that reads as though they will withhold payment to providers that do not have compliance program in place.  Don’t worry, we can help you with a simple compliance program that is affordable.

A few other items that impact business decisions. This takes effect 3/25/2011 for all new providers and March 2012 for all existing providers.

1.  Moratorium on Medicare, Medicaid & CHIP provider numbers based on products and number of suppliers in the area.  This may not be as easy anymore.

2.  Application fees of $500 each for all providers excluding physicians and nurse practitioners and their group practices. If a provider applied for Medicare and Medicaid then only one fee will be required, but proof of Medicare application may be required.

3.  New screening and Fingerprinting requirements. Note Florida has had fingerprinting in place for over 8 years. You have to have a criminal record and there are many fraudulent providers that currently do not have a record. This applies to owners of 5% or more of the company, directors and officers.

4.  Unscheduled & unannounced visits to check up on suppliers.

5.  Re-enrollment for Medicare every 3 years and Medicaid annually and fees will apply plus inflation rate for CPI.

6.  New state licensing requirements to come from this also.

If you do not have a compliance program or haven’t taken your seriously, it is a requirement that could result in suspended payments.

With proven experience in the health care compliance, We can help you with a compliance program policies and procedures as well as teach you to manage your program or help you manage the program to ensure you pass the government inspection to ensure effect within 3 years of implementation. They can request random audits for privacy and security to ensure you are meeting requirements and now they have added billing compliance.

We can also help you with provider applications to ensure they are done right the first time.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Happy Holidays!


Warm Holiday Wishes to You

Happy Holidays!  May you be blessed with the riches of life.  As we wind down the year, the holidays are a time to spend with friends and family sharing joy, laughter, and love.  The holidays are also a time of reflection and gratitude.  I want to thank each of you for making this a successful happy year, it has been a true gift in my life.  So many of you are friends, business advisers, business partners, clients, and maybe all of these, but you are truly appreciated.  Some of you make me reflect more often than I might like but I’ll keep you anyway..LOL.  I wish each of you a happy and safe holiday that is a road to a successful new year for you, your family and business.   I look forward to you being a part of my life in 2011 too.

Remember to pray for our soldiers and their families during the holidays, and if you see them during travels thank them.

How to Connect with Medical Auditing Solutions LLC?


You can find a complete scope of services under my blog.  In short, I work with most types of health care providers to setup compliance programs and training and anything that impacts cash flow.

You can follow us through our blog by scrolling to bottom of this blog, click follow then enter your email address.

You may follow Angela Miller and Medical Auditing Solutions if you a a profile on any of the following:

Website: http://www.medicalauditingsolutions.com
Blog: http://www.angelamillermas.wordpress.com or via website
Linkedin: http://www.linkedin.com/in/medicalauditingsolutions
Twitter: http://twitter.com/AngelaMillerMAS
Facebook: http://www.facebook.com/home.php#!/MedicalAuditingSolutions

Those who have recently attended a speaking engagement, I am connecting you through my blog. If you want to connect on the other sites feel free. I do not send out many email blast and utilize my blog the most.

15 Minute Thoughts “Conflict of Interest” & “Role of Compliance Officer”


UPDATE:

September 8, 2010      Conflict of Interest: Pay Attention or Write a Big Check – CANCELED

There will be no live program this Wednesday.

Reminder, Tune back on next Wednesday

September 15, 2010    Compliance Officer:  Who? What? …Really?

We will discuss who can be the compliance officer.  We will discuss the roll of the compliance officer as well as who should be the “supervisor” of the compliance officer.  With the requirement for all health care providers to have a compliance program fully implemented as part of the health care reform bill, this program is for physicians, DME, HME, home health, hospice, pharmacies and other health care providers that bill Medicare and Medicare.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

HITECH Compliance & Implementation Tips Happy Hour


Starts: Wednesday October 27, 2010, 05:30PM CDT
Ends: Wednesday October 27, 2010, 07:00PM CDT
Event Type: Conference
Location: BlackFinn
4440 Beltline Rd
Addison, TX  US
Intended for: Physicians, Office Managers, Information Technology Managers, Privacy Officers, Health Care Attorneys, Owners, Upper Management, Senior Level Management
Industry: hospital, physician, dental, pharmacy, DME, home health care
RSVP: kpearson@marjencapital.com or angela@medicalauditingsolutions.com
Organization: Marjen Technology Group & Medical Auditing Solutions LLC

This event is exclusively for health care providers and health care attorneys due to the content of the program. Please RSVP as seating is limited to 35.

HIPAA HITECH Happy Hour Drink Coupons & Appetizers Provided

We will provide a short presentation on new HITECH HIPAA highlights 6:00pm-6:30pm allowing time for Q&A

Topics:  Meaningful Use, What is Encrypted, and Tips to encryption without breaking the bank

Speakers:   Karen Pearson & Raj Croager Marjen Technology Group

Angela Miller Medical Auditing Solutions LLC

There will be prizes worth showing up for such as a new WatchGuard firewall that protects PHI before it leaves and Consulting Certificates.

MARJEN Technology Group is a privately held technology services company located in Arlington, Texas, bringing over two decades of experience to Dallas/Fort Worth area businesses.  Our mission is to bring enterprise class technology and services, at affordable prices, to small and medium size businesses.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

HIPAA Privacy Settlement – $1 Million


With all the new enforcement efforts for privacy violations, better read this and take note.  If you are not sure you are HIPAA compliant MAS can provide security as well as chart and process assessment to help you.  This article is so important, I couldn’t find the short link so recopied exact with all Ms. Stamers contact information as well.

Rite Aid Agrees to Pay $1 Million to Settle HIPAA Privacy Case As Office of Civil Rights Proposes Tighter HIPAA Privacy & Security Regulations

August 4, 2010 <!–Cynthia Marcotte Stamer–>

Stay Tuned To Solutions Law Press For More Details

One of the nation’s largest drug store chains, Rite Aid Corporation and its 40 affiliated entities (Rite Aid) will pay $1 million to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.  The U.S. Department of Health and Human Services (HHS) Office of Civil Rights announcement of the HIPAA resolution agreement with Rite Aid and the concurrent negotiation of a separate consent order of potential FTC Act violations between Rite Aid and the Federal Trade Commission (FTC) follows HHS’ announcement of proposed changes to its HIPAA Privacy Rules and associated penalties in response to changes enacted under the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act).  The Rite Aid settlement and the proposed Privacy Rule changes illustrate the growing penalty risks that health care providers, health plans, healthcare clearinghouses and their business associates (Covered Entities) face for violating the Privacy Rules.

Rite Aid Resolution Agreement

The Rite Aid resolution agreements settle charges that Rite Aid failed to appropriately safeguard the privacy of its customers when disposing of identifying information on pill bottle labels and other health information. The settlements apply to all of Rite Aid’s nearly 4,800 retail pharmacies and follow an extensive joint investigation by the HHS Office for Civil Rights (OCR) and the FTC.

OCR opened its investigation of Rite Aid after television media videotaped incidents in which pharmacies were shown to have disposed of prescriptions and labeled pill bottles containing individuals’ identifiable information in industrial trash containers that were accessible to the public in a variety of Rite Aid locations in cities across the United States.  OCR and FTC previously settled a similar case involving the national drug store chain CVS in February 2009.

The HIPAA Privacy Rule requires covered entities to safeguard the privacy of patient information and other “protected health information” including during its disposal.  In addition to the detailed requirements for protection and safeguarding of protected health information and electronic protected health information under the Privacy Rules, breach notification rules added to HIPAA under the HITECH Act also generally require that Covered Entities investigate and provide timely notification of breach to patients, OCR and in some cases the media when “unsecured protected heath information” is breached.  Meanwhile, the FTC Act and associated regulations require those retailers and certain other parties receiving personal financial information to comply with certain requirements for the protection and use of that information and to provide certain notifications of their privacy polices for protecting personal financial information.

The joint OCR and the FTC investigations raised concerns that:

  • Rite Aid failed to implement adequate policies and procedures to appropriately safeguard patient information during the disposal process;
  • Rite Aid failed to adequately train employees on how to dispose of such information properly; and
  • Rite Aid did not maintain a sanctions policy for members of its workforce who failed to properly dispose of patient information.

Under the HHS resolution agreement, Rite Aid agreed to pay a $1 million resolution amount to HHS and must implement a strong corrective action program under which Rite Aid agreed to:

  • Revise and distribute its policies and procedures regarding disposal of protected health information and sanctioning workers who do not follow them;
  • Train workforce members on these new requirements;
  • Conduct internal monitoring; and
  • Engage a qualified, independent third-party assessor to conduct compliance reviews and render reports to HHS.

In addition, under its FTC consent order, Rite Aid separately agreed to external, independent assessments of its pharmacy stores’ compliance with the FTC consent order.

The HHS corrective action plan will be in place for three years; the FTC order will be in place for 20 years.

Proposed Privacy Rule Changes

The Rite Aid resolution agreement and consent order follows the July 8, 2010 publication by OCR of proposed changes to its existing HIPAA Privacy, Security, and Enforcement Rules in response to amendments enacted under the HITECH Act. Because of the lead time required to implement needed changes in policies, technology and training, Covered Entities need to begin preparations to adjust their health information privacy and data security policies and practices in anticipation of the finalization and implementation of these rules as well as to act quickly to submit their comments about the proposed changes.  .

The more than 220 page Notice of Proposed Rulemaking (NPRM) proposes to revise the existing Standards for Privacy of Individually Identifiable Health Information (Privacy Rule); the Security Standards for the Protection of Electronic Protected Health Information (Security Rule); and the rules pertaining to Compliance and Investigations, Imposition of Civil Money Penalties, and Procedures for Hearings (Enforcement Rule) issued under HIPAA.

The author of this update, attorney Cynthia Marcotte Stamer, has extensive experience advising and assisting health care providers and other health industry clients with HIPAA and other privacy and data security, reimbursement, compliance, public policy, regulatory, staffing, and other operations and risk management matters. Ms. Stamer also is regularly conducts training on HIPAA and other health industry compliance, management and operations matters.  You can get more information about her health industry experience here.  If you need assistance with these or other compliance concerns, wish to inquire about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872  or via e-mail here.  You may link to her on Plaxo and Linkedin as well where she posts she articles.

Your Duck is Dead


I seem to share bad and/or scary crazy news so thought I would share a laugh today. This is a cute joke that is clean and will make you laugh and you can share with patients.

Your Duck is Dead

A woman brought a very limp duck into a veterinary surgeon. As she laid her pet on the table, the vet pulled out his stethoscope and listened to the bird’s chest.

After a moment or two, the vet shook his head and sadly said, “I’m sorry, your duck, Cuddles, has passed away.”

The distressed woman wailed, “Are you sure?”

“Yes, I am sure. Your duck is dead,” replied the vet..

“How can you be so sure?” she protested. “I mean you haven’t done any testing on him or anything. He might just be in a coma or something.”

The vet rolled his eyes, turned around and left the room. He returned a few minutes later with a black Labrador Retriever. As the duck’s owner looked on in amazement, the dog stood on his hind legs, put his front paws on the examination table and sniffed the duck from top to bottom. He then looked up at the vet with sad eyes and shook his head.

The vet patted the dog on the head and took it out of the room. A few minutes later he returned with a cat. The cat jumped on the table and also delicately sniffed the bird from head to foot. The cat sat back on its haunches, shook its head, meowed softly and strolled out of
the room.

The vet looked at the woman and said, “I’m sorry, but as I said, this is most definitely, 100% certifiably, a dead duck.”

The vet turned to his computer terminal, hit a few keys and produced a bill, which he handed to the woman..

The duck’s owner, still in shock, took the bill. “$150!” she cried, “$150 just to tell me my duck is dead!”

The vet shrugged, “I’m sorry. If you had just taken my word for it, the bill would have been $20, but with the Lab Report and the Cat Scan, it’s now $150.”

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.