Healthcare Risk Management – January 1, 2017
January 1, 2017
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Freestanding EDs Can Have Special Compliance, Liability Concerns
As hospitals increasingly look to freestanding EDs as a way to serve patients better while potentially increasing profits, legal and compliance experts caution risk managers that they may bring risks beyond the familiar concerns of a hospital-based ED.
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Freestanding EDs Growing in Popularity
Hospitals are opening freestanding EDs (FSEDs) at a rapid rate and mostly in states that allow them without meeting “determination of need” requirements.
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Report Overpayments to CMS Carefully to Avoid More Trouble
CMS expects hospitals and healthcare systems to report overpayments within 60 days of discovery to avoid false claims allegations, but knowing when and how to report is not always easy.
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Understand Discovery Rule, How to Avoid its Effects
The discovery rule can determine whether a potentially costly malpractice case will proceed, so understanding how it works is important for risk managers.
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Radiology Practice Settles FCA Claims for $8 million
A radiology group in New York has agreed to pay $8 million to settle claims that it knowingly submitted false claims to Medicare and Medicaid.
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UMass Settles HIPAA Violations After Malware Infection
A malware infection cost the University of Massachusetts Amherst $650,000 for potential HIPAA violations, and the school must comply with a corrective action plan.
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Caution: Fake HHS HIPAA Email Is Phishing Scam
The Office for Civil Rights has issued an alert warning healthcare providers about a phishing scam disguised as an official communication from the Department of Health and Human Services.
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CMS Offers New Settlement for Billing Denials
CMS is offering a new settlement deal for disputed billing denials, offering 66 cents on the dollar in exchange for hospitals dropping their appeals.
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Untreated Blood Clot Leads to Leg Amputation and $25 Million Verdict
A patient received a $25 million verdict after losing left leg to amputation due to untreated blood clot.
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Jury Awards $10 Million for Wrongful Death of Newborn
A patient sued the hospital and physician, alleging their negligence caused the baby’s wrongful death.