Archive for February, 2014

It is that Time Again

It is that time again when the Office of Inspector General (“OIG”) publishes its Work Plan for the fiscal year outlining the areas of focus that it will investigate. The Work Plan highlights the OIG’s top priority to “fight fraud, waste and abuse”. The OIG’s strategic plan for fiscal year 2014 through 2018 specifically references using data analytics and risk assessments to identify suspected fraud, waste and abuse. The OIG also utilizes enforcement resources, including, but not limited to its partnership with the Department of Justice to impose penalties and potential criminal or administrative actions against individuals or entities who have allegedly committed fraud. All healthcare providers are subject to the OIG’s enforcement actions. Accordingly, it is imperative for each healthcare provider to establish an effective compliance program. Healthcare providers should utilize this Work Plan to establish what types of audits should be conducted during the …

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Time is Running Out for ICD-10

ICD-10 is not a bad word but sometimes it sounds like one. The estimates for cost of transition from ICD-9 to ICDE-10 in a small practice is expected to range from over $50,000- $80,000 according to the Nachimson Advisors Studies. However, many providers continue to drag their feet hoping the cost will go away but, from all indications, it won’t this time. The deadline for implementation of the new codes is October 1, 2014.

ICD-10 is the International Classification of Disease tenth revision. This is a coding system created by the World Health Organization that codes for diseases, signs, symptoms, complaints, social circumstances, and other clinical descriptions that are documented in the medical records of hospital and ambulatory medical settings. Most people relate the coding to medical billing. When your physician accurately codes to support clinical services this can lead to better financial reimbursement for their medical practice. Most importantly it can correctly …

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Obamacare: Two Steps Forward, One Step Back

Friend and fellow blogger, Wayne Oliver, give a harsh critique of the Affordable Care Act (ACA) / Obamacare.  I felt compelled to respond and add my thoughts to the conversation, from the perspective of an executive working in the industry.

To begin, I think it fair to say that most people don’t fully understand the law.  Last September, the Washington Post stated that 62 percent of Americans said that they don’t have the information they need to understand the law.  Furthermore, most Americans, or 55%, disapprove of the way the President is handling the implementation of the new healthcare law.  So, it’s not a surprise that there has been loud objections by pundits and general disapproval by the public.  It is a complex law and, by most measures, the Administration has done a poor job of explaining it.  Yet, it doesn’t mean that there isn’t substance there.  In fact, a number of changes have already helped millions of average Americans and has the potential …

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ObamaCare: One Step Forward, Two Steps Backward

flaD AND STETHISCOPEI have been rather vocal in my opposition to the Affordable Care Act (or ObamaCare). There have been too many problems, too many issues and too many unintended consequences.

According to a report released this week by the non-partisan Congressional Budget Office (CBO), ObamaCare will “reduce the supply of labor by the equivalent of roughly 2.3 million full-time workers through 2021.”

Just as the economy is attempting to recover, we are moving forward with the implementation of a federal healthcare disaster that will kill even more jobs.
There is some good news. There is a new, legitimate “repeal and replace” movement led by US Senators Orrin Hatch (R-Utah), Richard Burr (R-NC) and Dr. Tom Coburn (R-Oklahoma). This “repeal and replace” effort has substance and includes many thoughtful, private sector based reforms and includes some of the provisions of ObamaCare that address access to health coverage.

The new Patient CARE (Choice, Affordability, …

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