Outpatient Facility Coding Alert - 2015 Issue 16
Industry Notes
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Article Overview
This industry news piece reviews recent enforcement actions and legal developments involving Medicare fraud, hospice and home care kickback schemes, money laundering, and privacy concerns tied to patient medical records. It is useful for providers, compliance staff, coders, and administrators who want a broad view of current audit, fraud, and HIPAA-related risk areas without going into premium article details.
Why This Topic Matters
The article highlights how fraud investigations and privacy incidents can trigger criminal penalties, repayment obligations, audits, and organizational scrutiny. It also underscores the operational importance of compliance programs and HIPAA training for healthcare practices and facilities.
Article Sections
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Physician Kickbacks Lead to Jail Time
Covers enforcement activity involving home care and hospice fraud, including allegations of kickbacks, false records, audit-related misconduct, and related criminal sentencing outcomes in multiple states.
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Questions Abound for Hospital After ESPN Publishes NFL Star’s Records
Discusses a hospital privacy controversy involving a player’s medical record, the resulting attention to HIPAA obligations, and the broader compliance concerns raised for healthcare organizations.
What You Will Learn
- The general types of fraud and privacy issues described in recent healthcare news.
- How enforcement actions can affect home care, hospice, and hospital organizations.
- Why HIPAA awareness and staff training remain important in practice settings.
- What broad compliance themes are emphasized by current healthcare investigations and lawsuits.
Who Should Read This
- Healthcare providers
- Compliance officers
- Medical coders
- Practice administrators
- Revenue cycle staff
- Health information management professionals
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