tci Medicare Compliance & Reimbursement - 2014 Issue 12
Industry Notes: One Physician Causes Biggest HIPAA Settlement in History
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Article Overview
This industry update covers three health care compliance and oversight topics: a high-profile HIPAA breach settlement involving electronic protected health information, a federal OIG report on Medicare recoveries and program integrity efforts, and an OIG review of state background check requirements for home health workers. It is relevant to compliance staff, health information managers, billing and audit professionals, and leaders overseeing privacy, Medicare integrity, or home care workforce policies.
Why This Topic Matters
The article highlights privacy, fraud-and-abuse oversight, and workforce screening issues that can affect risk management and regulatory compliance in health care organizations. It also points readers to federal reporting trends and state policy differences that may influence operational practices.
Article Sections
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HIPAA settlement and breach involving hospital ePHI
Discusses a privacy incident affecting hospital electronic protected health information and the resulting federal settlement. The section also notes the scope of the impacted individuals and the source of the public disclosure.
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OIG recoveries and Medicare program integrity report
Summarizes a semiannual OIG report on recoveries and oversight activities tied to Medicare and related contractor performance. The section focuses on broad enforcement themes and federal oversight concerns.
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OIG review of home health employee background checks
Reviews an OIG report on state requirements for background checks for home health agency employees. The section covers state policy variation, grant activity, and related workforce screening issues.
What You Will Learn
- How a HIPAA privacy breach can lead to a large federal settlement
- What the OIG reported about recoveries and program integrity activities
- How state background check requirements for home health workers vary
- Why privacy, audit, and workforce screening issues matter for health care compliance
Who Should Read This
- Health information management professionals
- Compliance officers
- Billing and audit staff
- Home health administrators
- Privacy and security officers
- Health care executives
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