Category Archives: Healthcare Compliance

QAPI Culture

Develop a Proactive QAPI Culture & Meet New CMS Nursing Requirements

Take a peek at the QAA/QAPI worksheet that surveyors use

Dealing with Quality Assurance and Performance Improvement (QAPI) compliance isn’t exactly new—but the Centers for Medicare & Medicaid Services (CMS) has recently thrown you a curveball. In an effort to help nursing facilities cultivate a proactive QAPI culture, the agency has unveiled new requirements. Here’s More..

HIPAA Breach

To Report Or Not To Report A HIPAA Breach

Use these evaluation and prevention strategies to minimize fines and breaches

As a HIPAA-covered entity, your medical establishment is required by the HIPAA Breach Notification Rule to provide notification following a breach of unsecured protected health information (PHI). Depending on the number of individuals your PHI breach affects, you may need to notify each affected individual, More..

RAC Appeals

Watch for New Issues in the RAC Appeals Process

Expect a mad dash to eliminate the backlog

For years, you’ve endured an agonizingly slow claims appeals process due to the enormous backlog of pending appeals. But now, the U.S. Department of Health and Human Services (HHS) Office of Medicare Hearings and Appeals (OMHA) is rapidly speeding things up. Find out what this More..

Evaluation and Management

Prepare Now for an E&M Reimbursement Revolution

Your payment will be cut in half when you use modifier 25

Ground-breaking changes to Evaluation and Management (E&M) documentation and payment are on the horizon, and the impact will vary widely depending on your specialty. Can you look forward to a pay bump—or a reimbursement reduction? Read on to find out. The scoop: CMS recently released More..

Ligature Risk

Take 4 Major Steps to Comply with CMS/TJC Ligature Risk Standards

Beware: You’ll have only 60 days to correct suicide-risk deficiencies

Psychiatric hospitals and psychiatric units within general hospitals aren’t the only places that must comply with ligature risk-related safety regulations. Now, The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) are cracking down on all hospitals and other healthcare settings to More..