Onslow Memorial Hospital Compliance

Current Topics

Face Validity Assessment of ABNs Required on All Complex Medical Reviews

On December 10, 2010, CMS issued transmittal R361PI requiring that a mandatory Advanced Beneficiary Notice (ABN) be requested as part of the additional document requests (ADR) on all claims undergoing complex medical record review.  This transmittal applies to Medicare administrative contractors (MACs), affiliated contractors (ACs), fiscal intermediaries (FIs) and carriers, Comprehensive Error Rate Testing Program […]

Final Rule Issued Requiring Full and Equal Privileges for all Visitors Requested by Patient

In November, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that allows patients to decide whom they want by their bedside in the hospital.  The rule includes protections when the visitor is a same-sex domestic partner. This rule changes the Medicare Conditions of Participation for hospitals effective January 18, 2011 and […]

Recovery Audit Contractors Begin Medical Necessity Audits

The Recovery Audit Contractor (RAC) program is an effort by the Centers for Medicare and Medicaid Services (CMS) to reduce improper payments within Medicare programs as well as identify process for improvements to reduce or eliminate future improper payments. Connolly Healthcare, the contractor selected by CMS to provide recovery audit services in this region, has […]

Janitor Sells Boxes Containing Protected Health Information

Media Health Leaders reports that the janitor at the Martin Luther King, Jr. Multi-service Ambulatory Care Center in Willowbrook, California sold 14 boxes containing 33,000 patient records to a recycling center for paper value equaling $40.  The ambulatory care center told officials that the records contained no Social Security numbers or any medical record numbers, but […]

DHHS releases final rule clarifying incentive payment requirements for EHRs under HITECH

On Tuesday, July 13, 2010, the U.S. Department of Health and Human Services released final rules to clarify how eligible healthcare professionals and hospitals may qualify for the Medicare and Medicaid incentive payments provided under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. Under the HITECH Act, providers qualify for […]

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