ICD-10 updates, Fraud, Waste, and Abuse Training, Booklets and Prevention

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We try to share useful information as we come across it. Below are some links that we think may be of interest to our audience such as: ICD-10 updates, Fraud, Waste, and Abuse Training, Booklets, and Prevention. We have also included some videos from YouTube. Be sure to follow the guidelines set forth and do not let hindsight get you in trouble.

ICD10 Code sets revised:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ICD9-10CM-ICD10PCS-CPT-HCPCS-Code-Sets-Educational-Tool-ICN900943.pdf

This is about 88 minutes, we thought it had some good content. Web-based Fraud, Waste, and Abuse Training:

https://www.cms.gov/Outreach-and-Education/MLN/WBT/MedicareFraudandAbuse/FraudandAbuse/story.html

Medicare Fraud-Abuse Booklet:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Fraud-Abuse-MLN4649244.pdf

Medicaid Fraud Prevention:

https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Program/Education

For those who do not think they are serious about this, here is a link for enforcement:

https://oig.hhs.gov/fraud/enforcement/?type=criminal-and-civil-actions

OIG Compliance Resource Portal:

https://oig.hhs.gov/compliance/

Evaluation and Management Services Guide:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/eval_mgmt_serv_guide-ICN006764TextOnly.pdf

OIG Videos:

False Claims Act https://www.youtube.com/watch?v=BbZ78QTLztQ&list=PLkw9IKOokUiIjlyjm7wsvZd31z0U8QxxP&index=42&t=26s

Federal Anti-Kickback Statute https://www.youtube.com/watch?v=a4KhqqeAaUg&list=PLkw9IKOokUiIjlyjm7wsvZd31z0U8QxxP&index=43&t=9s

Physician Self-Referral Law

Exclusion Authorities and Effects of Exclusions

How to use the LEIE Online and Downable Databases

Eye on Oversight: Kick Backs to Physicians

Eye on Oversight: Medicare Part D Fraud

If you need assistance with HIPAA Risk Management, or guidance with your HIPAA Compliance contact us at 877.659.2467 or complete the contact us form.

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About Suze Shaffer

Suze Shaffer is the owner and president of Aris Medical Solutions. She specializes in HIPAA compliance, risk management, and cyber security. She believes that by educating her clients in understanding why and what needs to be done to protect their practice they have a better outcome.

Suze has been instrumental in helping clients nationwide with risk management, implementing privacy and security rule policies and procedures, and ultimately protecting patient data. She includes state and federal regulatory requirements to ensure clients are protected in all areas.

She has spoken at numerous conferences and functions. She continues to educate organizations how to minimize the risks of data breaches. HIPAA compliance is not an option, it is mandatory for every organization that comes in contact with protected health information to have reasonable and appropriate security measures in place. Unfortunately, most organizations don’t realize they are not compliant until they suffer a data breach or they are faced with an audit or investigation.

Did you know that the Office for Civil Rights (OCR) is the agency that investigates data breaches? Have you seen the heavy fines that have been imposed for non-compliance?

All 50 states now have their own set of privacy laws and the State's Attorney General may also investigate privacy violations!

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