Monthly Newsletter – Earn CEUs

SEPTEMBER 2020

Monthly Newsletter
View the Previous Monthly Newsletter:
August 2020
View the Archived Monthly Newsletter:
July 2020

EHR Company Pays $500,000 to Resolve FCA Alllegations

Whistleblower Case Involving EXA EHR software


Allegations made in a lawsuit filed under the qui tam (whistleblower) contends that Viztek LLC, a former subsidiary of Konica Minolta Healthcare Americas, Inc. fraudulently obtained certification of EXA E.H.R. to be in compliance with HHS requirements for the Medicare incentive program.  The Department of Justice (DOJ) announced in a press release on August 27, 2020 that Viztek caused users to submit false claims by misrepresenting the capabilities of its electronic health records (EHR) software.  Click Here to read the DOJ Press Release.



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Government Obtains more than $5 million in judgements to resolve healthcare fraud against Georgia chiropractor, practice

A Brunswick, Ga. chiropractor Jennifer Heller, D.C. and her medical practice Heller Family Medicine LLC and have been ordered to pay more than $5 million to resolve a civil fraud complaint filed by the federal government. Dr. Heller and her medical practice violated the False Claims Act by submitting claims to the Medicare Program for hundreds of surgical procedures involving implantable neurostimulators, when in actuality the practice used an acupuncture device commonly referred to as a “P-Stim.” The “P-Stim” device provides stimulation by electrical impulses when affixed with an adhesive behind a patient’s ear.  Click Here to read more about this case.


Resources:

Early Release:  LCD A58345 Billing & Coding Chiropractic Services 

Effective October 1, 2020 a new Local Coverage Determination (LCD) is implemented regarding Medicare’s requirements for Chiropractic Services. The LCD lists the most common reasons for claim denials, documentation requirements and coding information from MAC Novitas Solutions for many states across the country.  Click Here to download your early PDF.

Online Training

Training is designed for Medical Billing Companies, Auditors, Investigators, Providers, Insurance Carriers, Chiropractic Front Desk Staff, Coders and Billers. Click Here to learn more, Click Here to register online


HHS Releases $1.5 Billion to States, Tribes to Combat Opioid Crisis August 27, 2020 

The U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA) is distributing the first-year funds of its two-year State Opioid Response (SOR) and Tribal Opioid Response (TOR) grant programs. The two programs ultimately will award nearly $3 billion over two years to help states and tribes provide community-level resources for people in need of prevention, treatment and recovery support services.  Click Here to read the August 27, 2020 HHS News Release for more information.


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CMS Updates

Hurricane Laura Updates

The Centers for Medicare & Medicaid Services (CMS) have efforts underway to support Louisiana and Texas in response to Hurricane Laura. On August 26, 2020, Department of Health and Human Services (HHS) Secretary Alex Azar declared public health emergencies (PHEs) in these states, retroactive to August 22, 2020 for the state of Louisiana and to August 23, 2020 for the state of Texas. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of Hurricane Laura.  Click Here for more information.  


Donate to the Hurricane Relief Efforts – We have a portal on our home page for those interested in making a Red Cross donation to help those in need.



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Test Your QPP Website Access Before Network Security Update

To increase network security, CMS announced a mandatory update will be applied to the Quality Payment Program (QPP) systems in fall 2020. As a result, you may not be able to  access https://qpp.cms.gov/ if you have an outdated:

  • Windows operating system (7 or 8.1) and Version 11 of Internet Explorer;
  • Mac OS and iOS with an outdated version of Safari; or
  • Version of Google Chrome, Mozilla Firefox, or Microsoft Edge.

We encourage you to test your web browser and make any necessary updates to ensure your continued access to qpp.cms.gov. Test your browser here now to see if it will allow you to access the QPP website after the security update this fall.  Go to https://qpp.cms.gov/ for more information.


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CMS Data Reports Trend of Incomplete or Incorrectly Enacted Hospice Plan of Care

New Fact Sheet ICN MLN9895410 August 2020

CMS analyzed 2019 data and found common survey deficiencies related to Plan of Care (POC) implementation.  The Fact Sheet report examples of deficiencies found, such as:

  • POCs were not individualized
  • Hospice staff missed direct-care visits
  • Documentation of visits did not meet requirements (for example, wound care)
  • POCs were incomplete (for example, not inclusive of all needed services)
  • IDG meetings were inconsistent, with POCs not being updated

The hospice provider develops an individualized plan of care (POC), established by an Interdisciplinary Group (IDG) and overseen by a Registered Nurse (RN) coordinator.  The IDG is positioned to support and manage the physical, medical, psychosocial, emotional, and spiritual needs of hospice patients and families through an individualized POC. The IDG establishes the POC at the time an individual elects  hospice, and continuously updates the POC while the patient gets the hospice benefit. Additionally, the hospice must offer a bereavement POC and supportive services to the caregiver/family for one year after the death of the hospice patient to further support the bereaved family.


Click here to download the August fact sheet to learn more.


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