Medicaid and Medicare
Best Practice Case Management Roles and Functions: How to Optimize RN and Social Worker Skill Sets
This session will discuss the roles and functions of staff in a case management department that are needed to support the department’s goals through collaborative professional processes. The skill sets and characteristics for the role of the RN case manager and the social worker will be reviewed, as well as identifying the most contemporary functions needed to respond to changes brought on by healthcare ref..
Case Management: Find and Fix Your 2019 Compliance Gaps
As case managers, we must be aware of the myriad of compliance issues that we must adhere to in our daily practice. Never has this been more important to our work as case managers than it is now. Our ability to remain compliant has become an element of audits from accrediting bodies such as the Joint Commission as well as the Centers for Medicare and Medicaid Services (CMS). It is the right thing to do for ..
Compliance Measures for Case Management Professionals
As case managers, we must be aware of the myriad of compliance issues that we must adhere to in our daily practice. Never has this been more important to our work as case managers then it is now. Our ability to remain compliant has become an element of audits from accrediting bodies such as the Joint Commission as well as the Centers for Medicare and Medicaid Services (CMS). It is the right thing to do for ..
Coronavirus and Influenza
As this promotion reached our website, the Coronavirus is sweeping around the globe. Millions are quarantined in Chinese cities, where untold thousands are infected and the acknowledged death toll is climbing into four figures. Thousands of passengers and crew members are under lockdown on luxury cruise ships off the coasts of Japan and New Jersey. And the first cases have been reported in New York City.Ens..
False Claims Act (or Whistleblower Act) and Hospital Fraud
A whistleblower or qui tam action can provide financial rewards to individuals who provide information that a company, hospital, or individual has defrauded the government. The primary statutes under which this relief may be sought are the federal and state False Claims Acts (“FCAs”). State and federal governments pay hundreds of billions of dollars each year for pharmaceutical drugs, medical devices, hospi..
Fundamentals in Discharge Planning for RN and Social Work Case Managers
This program will review the current rules and regulations from the Conditions of Participation for discharge planning. We will then discuss the most recent changes from the Medicare program and how they will impact the roles of the RN case manager and the social worker. We will review strategies for safely transitioning your patients across the continuum of care. In addition, we will review how to engage o..
HIPAA and Social Media Violations of HIPAA’s Privacy Requirements
This webinar provides an overview of core privacy requirements of HIPAA. Then, the subject moves to the social media activities of healthcare practitioners. This webinar provides a brief summary of those basic HIPAA privacy protections then goes into detail on the many ways a health care provider may run afoul of the privacy exceptions via the use of social media. This may occur both when a healthcare pract..
HIPAA and Your Office Staff – How Their HIPAA Violations Can Get You in Trouble
This webinar provides an overview of core privacy requirements of HIPAA, the basics of which should be well-known and practiced by all health care practitioners. These provisions cover office staff and others. Then, the subject moves to patient privacy in a digital age, with a review of social media activities of health care practitioners and employees.This webinar thus provides a brief summary of those bas..
HIPAA Audits – an Insiders Perspective
I will be speaking to real life audits conducted by the Federal government for Phase 2 and beyond (I’ve been on both sides of these audits) what your highest risks are for being fined (some of the risk factors may surprise you). It seems almost daily I am receiving calls from nervous practice managers and compliance officers all over the USA regarding a HIPAA audit letter or call they have received. This le..
HIPAA Privacy and Public Health Exceptions: COVID-19 and the Coming Coronavirus Pandemic in the United States
This new and cutting edge webinar starts with the well-known basics of HIPAA privacy that should be routine for today’s medical practitioners. The rules are well-established and a part of modern medical education, training, and practice. While the basic provisions of privacy for protected health information are well known, their application for public health exceptions in today’s world is to be examined.&nb..
HIPAA training for the Compliance Officer
This webinar will be addressing how practice/business managers (or compliance offers) need to get their HIPAA house in order before the imminent audits occur. It will also address major changes under the Omnibus Rule and any other applicable updates for 2018. Areas also covered will be texting, email, encryption, medical messaging, voice data and risk factors as they relate to IT. The primary goal is to ens..
HIPAA vs SAMHSA (42 CFR Part 2)
This lesson will be addressing how practice/business managers (or compliance offers) need to ensure their organization is complying with the Federal Substance Abuse and Mental Health Administration (SAMHSA) regulations (42 CFR Part 2) and how this differs from the HIPAA (Health Insurance Portability and Accountability Act) Privacy and Security Regulations. Both regulations carry significant civil and even c..
How To Deal With the Disruptive Practitioner
Disruptive activity by practitioners in the hospital takes many forms. When it happens, it is important that the hospital and/or the medical staff take appropriate steps to see that it does not affect patient care or disrupt operations.Most disciplinary policies are progressive. A progressive policy applies increasingly more severe sanctions to additional incidents of bad behavior. It is very important that..
Infection Prevention Across the Construction Continuum: The Need for Planning for Renovation and Maintenance
Healthcare facilities continue to undergo a transformation as service lines and patient populations change. Construction, renovation, and maintenance of facilities provide legal, regulatory, business and ethical responsibilities to design, construct and maintain a safe environment for patients, their family, staff, and practitioners. An infection prevention risk assessment document provides guidelines for m..
The CMS Conditions of Participation for Discharge Planning
This program will review the current rules and regulations from the Conditions of Participation (CoP) for Discharge Planning. The CoP is the legal and regulatory requirements that hospitals and case management professionals must follow in order to be compliant in their role as discharge planners. This will be followed by a review of the changes to the Conditions of Participation for Discharge Planning that ..