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Mismatched BAAs and services agreements create legal snarls

07/19/2021

Make sure the terms in your business associate agreements (BAA) are consistent with the agreement that outlines the underlying services being provided by the business associate. If the two agreements are not in alignment and your practice later has a dispute with the business associate, a judge will likely decide which term applies, and his decision might not be in your favor.

7 steps to harmonize business associate, services agreements

07/19/2021

by: Marla Durben Hirsch

Inconsistencies between a business associate agreement (BAA) and the underlying services agreement it relates to can create legal headaches for your practice.

Incorporate social determinants of health into risk calculations

07/19/2021

by: Julia Kyles, CPC

Question: The medical decision-making table for office E/M visits (99202-99215), includes “Diagnosis or treatment significantly limited by social determinants of health” as one example of moderate risk. When can we count that toward a patient visit?

Numbers show public concern with surprise billing made new regs inevitable

07/19/2021

by: Roy Edroso

The new and upcoming rules related to surprise billing promise big changes for the health care industry, but as you can see from a series of figures from the Kaiser Family Foundation first published on Feb. 11, 2020, the issue had penetrated the consciousness of a large number of Americans and become a political issue that could hardly be ignored.

Mind legality of firing MD for embarrassing the practice; better to go no-cause

07/12/2021

by: Roy Edroso

The recent dismissal of a physician who bothered his employer with a self-published book is a good reminder that providers can affect your practice by their actions outside the office, and that you should be prepared for it in their contract terms.

First in series of surprise billing rules promises big payment, patient info changes soon

07/12/2021

by: Roy Edroso

The first of an anticipated series of rules related to surprise billing is out, and suggests that the government will enforce a low ceiling for out-of-network charges — and require practice physicians to explain to an unprecedented degree what payment options the patient has.

New HITECH amendment rewards good cybersecurity hygiene

07/12/2021

by: Marla Durben Hirsch

Now’s a great time to shore up your cybersecurity practices. A new amendment to the Health Information Technology for Economic and Clinical Health (HITECH) Act requires the HHS Office for Civil Rights (OCR) to take into account whether your practice adopted “certain recognized security practices” if it investigates your practice for HIPAA compliance. The amendment applies to business associates, too.

More than 8 million patients affected by HIPAA breaches this year

07/12/2021

by: Julia Kyles, CPC

Check on your practice’s network and email security protocols. A look at breaches reported by health care providers shows that hacking and IT incidents were associated with the largest breaches in the first six months of the year.

Go to the source when you count review of external notes

07/12/2021

by: Julia Kyles, CPC

Question: I understand how to count tests that are ordered or reviewed for office visits. But I’m not sure how to count “the prior review of external note(s) from each unique source.” Does the review of one note from one physician or qualified health care professional (QHP) from a different group or specialty count as one source?

Medicare Advantage takes another bite out of traditional FFS enrollment

07/12/2021

by: Richard Scott

Medicare Advantage enrollment galloped forward at a 10% rate between 2020 and 2021, as the private plan alternative to original Medicare now has lassoed more than four in 10 (42%) beneficiaries.

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