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HEADLINES
Thursday, May 29, 2008
Click on a headline below for the
full story.
On
The Front Lines
CCH®
Health Care Compliance Integrated
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The Health Care Compliance
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Health
Care Compliance Integrated Library
Clinical Research Compliance Manual An Administrative Guide
The Clinical Research Compliance Manual presents the main issues and provides analysis of the statutes and regulations associated with clinical research and trials. The 2008 Supplement includes the following new developments:
- Chapter 2, Human Subject Protections in Clinical Research, includes a new section on proposed additional protections for adults with impaired decision making capacity;
- Chapter 4, Institutional Review Boards, includes new sections on requirements for written IRB procedures, proposed changes to Expedited Review Category, IRB record-keeping requirements, 2007 law requiring the registration of clinical trials, use of computerized systems in clinical investigations;
- Chapter 10, A Practical Guide to Good Clinical Practice Standards, includes subsections on FDA inspections for clinical investigators and IRBs;
- Chapter 11, Key Concepts in Reimbursement for Clinical Trials, includes the 2007 clarification and changes to CMS' NCD for clinical trial policies;
- Chapter 12, Best Practices in Clinical Research Compliance, includes a new section on legal principles associated with clinical trial billing compliance;
- New Chapter 14, Research Privacy and Security: Myths, Facts and Practical Approaches, covers HIPAA privacy and security rules, Common Rule and FDA privacy and confidentiality provisions, state privacy and mandatory disclosure laws, electronic records and signatures, information security.
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Journal of Health Care Compliance
The May-June 2008 issue of the Journal of Health Care Compliance included the following feature articles:
- Government/Industry Roundtable Focuses on Quality of Care Oversight by the Board of Directors, by John Falcetano
- This article discusses the findings of the December 2007 compliance industry and OIG roundtable on longterm care board of director’s oversight of quality of care.
- The State of the Anti-Markup Rule Regarding Diagnostic Tests, by Kathy J. Tayon
- This article takes a closer look at the 2008 Medicare Physician Fee Schedule final rule, which among other things amends 42 C.F.R. Section 414.50 prohibiting the marking up of certain diagnostic tests when billing for these tests.
- The State of the Anti-Markup Rule Regarding Diagnostic Tests, by Kathy J. Tayon
- This article takes a closer look at the 2008 Medicare Physician Fee Schedule final rule, which among other things amends 42 C.F.R. Section 414.50 prohibiting the marking up of certain diagnostic tests when billing for these tests.
- A Structured Approach to Developing an Effective Internal Audit Program for Billing and Coding, by Michael Miscoe
- This article discusses how to develop and implement an effective coding and billing audit program through the use of a structured four-phased process.
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more. Subscribers only
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Headlines
Former HHS Secretary urges Congress to overhaul Medicare
Rather than relying on states to expand health
care coverage through pilot programs, the federal government should work to
fix the Medicare system, former HHS Secretary Tommy Thompson said at a Senate
Finance Committee hearing on May 6, 2008. CCH Washington Bureau, May 6, 2008. Full Story
Court finds no initial duty to disclose physician impairment
A hospital and physician group that wrote
referral letters on behalf of an anesthesiologist had no duty to disclose
to a future employer their investigation into the anesthesiologist's on-duty
use of narcotics, according to a recent decision by the fifth circuit court
of appeals. The court found, however, that the hospital and physician group
had a duty to avoid affirmative misrepresentations in the referral letters. Kadlec Medical Center v. Lakeview Anesthesia Associates,
5th Cir., May 8, 2008, Health Care Compliance Reporter p800,503. Full
Story
Legal health records' accuracy, authenticity crucial, experts say
When creating, correcting, and adding to a
patient's health record, it is crucial for legal purposes to make sure
the information is accurate and authentic and that the original record is
maintained, according to experts who spoke during a recent American Health
Information Management Association webinar on defining and maintaining the
legal health record. CCH Washington Bureau, May 5, 2008.
Full
Story
Senators agree to strengthen health IT bill privacy provisions
Senators working to protect the privacy and
security of personal health information have reached an agreement that will
advance negotiations over provisions in the Wired for Health Care Quality
Act ("Wired Act"), a bill sponsored by Senators Edward Kennedy
(D-Mass.) and Michael Enzi (R-Wyo.) to help establish a national health information
technology system. U.S. Senator Patrick Leahy Press Release, May 14, 2008. Full
Story
OIG rejects free labeling services arrangement
The Office of Inspector General (OIG) has
declined to approve a laboratory's proposal to provide certain services at
no cost to dialysis facilities because the arrangement could potentially generate
prohibited remuneration and subject the laboratory to administrative sanctions
under the anti-kickback statute, according to a recent advisory opinion. OIG Advisory Opinion, No. 08-06, May 2, 2008,
Health Care Compliance Reporter p500,185. Full Story
Enforcement data added to HIPAA privacy Web site
The HHS Office of Civil Rights (OCR) has added
new enforcement data to its Web site on Health Insurance Portability and Accountability
Act (HIPAA) privacy compliance. HHS Release, May 9, 2008. Full Story
Former employee pleads guilty to HIPAA violations
A former employee of a counseling center pled
guilty to violating the Health Insurance Portability and Accountability Act
by allowing two individuals to take patient files from the counseling center
with the intent to obtain personal gain. DOJ Press Release, May 8, 2008. Full Story
Drug distributor settles reporting violation claims
McKesson Corporation, a national distributor
of branded and generic prescription medications, has agreed to pay $13.25
million to resolve allegations that it violated federal reporting provisions
related to the sale of certain prescription medications regulated by the Drug
Enforcement Administration (DEA), the Department of Justice announced. DOJ Press Release, May 2, 2008. Full Story
Dermatologist found guilty of Medicare fraud
A federal jury in Miami convicted a dermatologist
of conspiracy to defraud the U.S. government, conspiracy to cause the submission
of false claims to Medicare, conspiracy to solicit and receive kickbacks,
and conspiracy to commit health care fraud, the U.S. Attorney for the Southern
District of Florida announced. U.S. Attorney, Southern District of Florida Press Release, April 30, 2008. Full Story
On The Front Lines
Medicare mark-up prohibition on diagnostic tests: Navigating compliance and coding implications
by Charles I. Artz, Esq. and Michael D. Miscoe, CPC, CHCC, Contributing Editors
Medicare providers have long been able to report comprehensive
diagnostic services when either the technical or professional component of
the service was "purchased" from an outside provider or entity.
An issue, however, has arisen regarding the circumstances in which this is
permissible and the fee that Medicare may be charged for the purchased component
of the test. CMS recently published new rules related to purchased diagnostic
services. Full
Story
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