The healthcare industry, and physician practices in particular, are experienced at weathering industry disruptors and a landscape that seems to be in perpetual change. However, the last few years have seen a notable increase in mergers and acquisitions, with all...
The Dos and Don’ts of Medical Payer Audits: How to Identify and Respond to Them
ABSTRACT Prior to the COVID-19 pandemic, medical providers were routinely audited by public and private payers. Since the pandemic, when many payers were forced to pay for expensive COVID-19 related testing and treatment, payer audits have increased. When a provider...
Challenges of Finding and Retaining Talent for Private Practices
As we have seen since April 2021, we are still being influenced by the Great Resignation or the Big Quit. COVID-19 was a wake-up call for many people in general, but even more so for employees who were not satisfied with their current roles in the workplace. Employees...
2021 Reflections
These are recaps of what they report as some of the trends and realities of compliance today
The Dangers of Undercoding
The innumerable horror stories related to payer audits have given rise to a new trend of undercoding, by intent! Many providers would rather be safe than sorry, all in the name of keeping their good names off the radar. However, undercoding can backfire, resulting in...
21st Century Cures Act and CMS Interoperability & Patient Access
The 21st Century Cures Act ("Cures Act") was approved by Congress in 2016 with the intent to provide electronic access, exchange, and use of health information across all different types of health care entities. On May 1, 2020, the Cures Act's final rule became...
The Public Health Emergency (PHE) Will Fade Away
On the day that President Biden was sworn into office, the public health emergency (PHE) was set to expire, but the Department of Health & Human Services extended the emergency declaration for another 90 days, to April 20, 2021. This represents the fourth time...
First Proposed HIPAA Privacy Rules Changes in 8 Years
In a response to the healthcare community’s desire to lessen the administrative burden on HIPAA covered entities, the Office of Civil Rights (OCR) issued a request of information (RFI) in December of 2018. Two years later, after this RFI comment period closed, the OCR...
Welcome to HCN ELEMENTS, our publication of information and insights on the everchanging regulatory compliance landscape.
ELEMENTS may seem like an unusual name for a newsletter but for us, the word is pretty much of a North Star. We use the “7 Elements of Compliance “to guide everything we do. A little history by way of explanation. In the mid 1990’s the CDC, OSHA and other government...