HIT Policy Committee’s Nationwide Health Information Network Workgroup Meets December 16, 2009

The Office of the National Coordinator for Health Information Technology (ONC) HIT Policy Committee’s Nationwide Health Information Network Workgroup will hold a public meeting on December 16, 2009.  The meeting is scheduled from 10 a.m. to 5 p.m./Eastern Time at the OMNI Shoreham Hotel, 2500 Calvert Street, NW., Washington, DC. Members of the public care invited to participate live, via telephone, or Webcast.  For details about options for participation, instructions to present input, and other details, see here.

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved.

Chisholm Trail Chapter Association of Certified Fraud Specialists December 11, 2009 Chapter Meeting & Luncheon Invite

The Chisholm Trail Chapter of the Association of Certified Fraud specialists invites members and other interested persons to attend its December 11, 2009 Chapter Meeting on December 11, 2009 beginning at 10:30 a.m. in the DCIS Conference Room located at 2201 N. Collins, Arlington, TX.

Interested persons should RSVP to and arrange for the required registration fee for the pre-paid luncheon (barbecue w/fixings) in the amount of $12.00 per person to be made payable to and received by the following no later than December 4, 2009:

Make checks payable to: Carlos Ontiveros, POB 227238, Dallas, Tx 75222-7238

To RSVP or for additional information, please e-mail here.

 We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved.

Medicare Paid Physicians More Than $92 Million in Incentives for 2008 Under the Physician Quality Reporting Initiative

Announcement Follows CMS’s Release of 2010 PQRI Program Details

More than 85,000 physicians and other eligible professionals who successfully reported quality-related data to Medicare under the 2008 Physician Quality Reporting Initiative (PQRI) received incentive payments totaling more than $92 million, up from the $36 million paid in 2007, according to a new Centers for Medicare & Medicaid Services (CMS) report.  The announcement of the 2008 statistics follows CMS’s recent announcement of its plan for the 2010 PQRI Program as part of the Medicare Physician Fee Schedule final rule.  A fact sheet on the 2010 PQRI Program is available online at here.  CMS reports it excepts the PQRI Program will continue to improve quality and provider participation will rise in 2009 and 2010.

According to CMS, physicians and other eligible professionals qualified for an incentive payment for the 2008 PQRI by satisfactorily reporting the required PQRI quality measures data received their payments this Fall.  CMS reports that:

• The number of eligible professionals who earned an incentive payment during 2008 increased by one-third from 2007, when 56,700 eligible professionals earned an incentive payment.  In 2007, eligible professionals could only participate in the program during a 6-month reporting period.  In 2008, the program expanded to allow reporting for either a 6-month or a 12-month period.
• The average incentive amount for individual professionals was over $1,000, with the largest payment to an eligible professional totaling over $98,000.
• More than 162,800 professionals participated in the 2008 PQRI. Of those, over 85,000 physicians and other eligible professionals met statutory requirements for satisfactory reporting for the 2008 reporting period and are receiving incentive payments. 
• Eligible professionals from all U.S. states and territories participated in PQRI in 2008.  Health practices with participating eligible professionals in Florida and Illinois received the highest incentive payments for the 2008 PQRI.  In Florida, eligible professionals received a total of over $7.5 million, and in Illinois, they received over $6 million.

Additional 2008 PQRI results, as well as information on how eligible professionals who participated in the 2008 PQRI, can access confidential feedback reports can be found in a CMS Fact Sheet here.

Established in late 2006 by the Tax Relief and Health Care Act, PQRI is a voluntary program that allows physicians and other eligible healthcare professionals to receive incentive payments for reporting data on quality measures related to services furnished to Medicare beneficiaries.  In the initial program years, physicians and other eligible professionals who satisfactorily submitted quality data for covered professional services furnished in the applicable reporting period were able to receive incentive payments of 1.5 percent of the total estimated allowed charges under Medicare Part B for covered professional services. In 2008 Congress extended the PQRI under the Medicare Improvements for Patients and Providers Act (MIPPA) and authorized incentive payments through 2010.

While the 2008 PQRI program included positive changes to ease the reporting of quality measures, CMS anticipates that the 2009 PQRI program provides enhancements that will make it even easier for physicians and other health care professionals to participate. Beginning in 2009, Congress increased the incentive that eligible professionals could receive for satisfactorily reporting data from 1.5 percent to 2.0 percent of the estimate of the allowed charges under Medicare Part B for all such covered professional services furnished during the applicable reporting period for 2009 and 2010.  CMS added 52 new quality measures for the 2009 PQRI year, raising the total number of measures to 153.  These new measures cover all types of healthcare professionals who provide services to Medicare beneficiaries, and address areas such as osteoarthritis, back pain, coronary artery disease, and HIV/AIDS, as well as 18 measures that must be reported exclusively through PQRI-qualified registries.  CMS hopes its recently announced 2010 PQRI Program will result in enhanced quality and further participation by physicians and other providers in 2010.

More information about the PQRI program, including participation guidance and the criteria to qualify for an incentive payment is available at www.cms.hhs.gov/PQRI.

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved.

OIG Review of High-Dollar Medicare Part D Payments Processed by First Coast Service Options, Inc. Shows Overpayments

The Office of Inspector General (OIG) is reporting that its review of certain high dollar Medicare Part B payments processed by First Coast Service Options, Inc., for Calendar Years 2004−2006  shows overpayments. 

According to  OIG Audit Report A-01-09-00513 posted at  http://www.oig.hhs.gov/oas/reports/region1/10900513.pdf, OIG found during calendar years 2004 through 2006 that First Coast Service Options, Inc. overpaid providers $114,783 for high-dollar (greater than $10,000) Medicare Part B claims.

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here,  by subscribing to receive these updates in blog form here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved.

Renal Dialysis Faculties Encouraged to Review Current Protocols for Administering Erthropoiesis-Stimulating Agents

Renal Dialysis Facilities are encouraged to review and consider the advisability for further tightening of their current practices in light of the Renal Dialysis Facilities’ Dosage Protocols for Administering Erthropoiesis-Stimulating Agents, (OEI-03-09-00010), posted by the OIG this week. 

According to the report, OIG conducted the report in response to a request from Chairman Fortney Pete Stark of the Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives in response to reported concerns by some members of Congress that dialysis facilities’ protocols for administering ESAs may not be consistent with the current boxed warning for these drugs. 

OIG found that 93 percent of Medicare-certified dialysis facilities had protocols in place for administering erythropoiesis-stimulating agents (ESA), but only 56 percent of the facilities’ protocols explicitly state a target hemoglobin range.  OIG could not determine whether the remaining 44 percent of protocols were consistent with the boxed warning and Medicare’s benefit policy because they do not specify a target hemoglobin range.  Of the protocols that state a target hemoglobin range, 94 percent are consistent with the boxed warning on FDA-approved labeling and the Medicare benefit policy for ESAs. 

While noting they are not required to do so, OIG commented that dialysis facilities may develop their own protocols for administering ESAs to patients with chronic kidney failure.  The protocols may define target hemoglobin levels and dosage instructions for administering ESAs.  According to the boxed warning on ESAs’ labels, maintaining higher rather than lower hemoglobin levels in a patient with chronic kidney failure can adversely affect the patient’s health and increase the risk of death.  Specifically, the boxed warning states that providers should administer ESAs “to achieve and maintain hemoglobin levels within the range of 10 to 12 g/dL.”  The Medicare benefit policy for ESAs reflects the target hemoglobin range specified in the boxed warning.  A separate Medicare policy for monitoring ESA payments states that CMS will reduce reported dosages upon which ESA claims are paid when patients’ hemoglobin levels exceed 13g/dL.

OIG reported its review of protocols to determine whether they are consistent with selected guidelines on ESAs’ labels revealed that some protocols contain information that differs from labeling guidelines regarding starting doses, dose adjustments, and withholding ESA doses.  OIG also found that all of the protocols that include a target hemoglobin range or level at which to increase ESA doses conform with CMS’s monitoring policy.

OIG concluded that although its review does not address the amount of ESAs that providers actually administer to patients at their dialysis facilities, it does demonstrate that just over half of facilities’ protocols for administering ESAs are consistent with the boxed warning and Medicare’s benefit policy for ESAs.  However, since almost half of the dialysis facilities either did not have protocols or did not specify a target hemoglobin range in their protocols, OIG reported it could not determine whether these facilities’ policies target the hemoglobin range outlined in the boxed warning that FDA requires on ESA labels.

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here,  by subscribing to receive these updates in blog form here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved.

 

North Texas Healthcare Compliance Professional Association Meets Nov. 10 At Medical City

Note New Meeting Time And Change Of Room Location!!!

November 10, 2009 Meeting Announcement & Agenda

3:00 – 5:00 p.m.

Medical City Hospital Cafetorium in Building A next to the Cafeteria

7777 Forrest Lane, Dallas, Texas

 The North Texas Healthcare Compliance Professional Association invites members and other interested health industry compliance professionals to its November 10, 2009 meeting to be held from 3:00 – 5:00 p.m. in the Cafetorium located in Building A next to the cafeteria at Medical City, 7777 Forrest Lane, Dallas, Texas. Please note the adjusted time and room location for this meeting!

Topics to be discussed include:

• An update on modifications/upgrades in Group One’s Compliance Check and the ability to use the Data Initiative to pull RAC specific indicators and a dashboard in development for Compliance Officer use from Kristin Jenkins of the Dallas/Hospital Council; and
• An update on “Emerging Issues & Trends in Medical Practice Valuations” by Don Barbo, Health Care Valuation Services Director, MidAmerica, Deloitte Financial Advisory Services, LLP.

 Complementary participation in the meeting is open to all NTHCPA members and other interested health care compliance professionals.  Please feel free to share this invitation with others who may be interested.

NTHCPA thanks Texas Health Resources for hosting the October 13, 2009 Meeting and Medical City for hosting the November 10, 2009 meeting.  

If you are interested in hosting one of the upcoming meetings, wish to suggest topics or speakers, or wish to obtain or share other information, please contact NTHCPA Vice-President Cynthia Marcotte Stamer at (214) 270-2402 or by e-mail at cstamer@solutionslawyer.net.

We look forward to seeing you at the meeting!

About the NTHCPA

NTHCPA exists to champion ethical practice and compliance standards and to provide the necessary resources for ethics and compliance Professionals and others in North Texas who share these principles.

The vision of NTHCPA is to be a pre-eminent compliance and ethics group promoting lasting success and integrity of organizations within North Texas.

To register or update your registration or to receive notice of future meetings, e-mail here.

This communication may be considered a marketing communication for certain purposes.  If you wish to update your e-mail for purposes of or would prefer not to receive future e-mail concerning meetings or other activities of the North Texas Healthcare Compliance Professionals Association or other marketing and promotional mailings from it, please send an email with the word “unsubscribe” in its subject heading  here.

2010 Medicare Part B Monthly Premium Rate, Annual Part B Deductible & Actuarial RatesAnnounced

The Centers for Medicare & Medicaid Services recently announced that the monthly premiums, actuarial rates for aged (age 65 and over) and disabled (under age 65) beneficiaries enrolled in Part B of the Medicare Supplementary Medical Insurance (SMI) program that will apply for calendar year 2010. 

The rates announced here in the Federal Register on October 22, 2009 are as follows:

• The monthly actuarial rates for 2010 are $221.00 for aged enrollees and $270.40 for disabled enrollees. The standard monthly Part B premium rate for 2010 is $110.50, which is up from the 2009
• standard premium rate of $96.40.)
• The Part B deductible for 2010 is set at $155.00 for all Part B beneficiaries.

A beneficiary who has to pay an income-related monthly adjustment may have to pay a total monthly premium of roughly 35, 50, 65 or 80 percent of the total cost of Part B coverage.

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved.

2010 Medicare Hospital (Part A) Premiums, Inpatient Deductibles & Copays Announced

The Centers for Medicare & Medicaid Services (CMS) recently announced that the Medicare Hospital Insurance (Part A) premium for uninsured enrollees in calendar year (CY) 2010 for the 12-month period beginning January 1, 2010 will be $461. This premium is paid by enrollees age 65 and over who are not otherwise eligible for benefits under Medicare Part A (hereafter known as the “uninsured aged”) and by certain disabled individuals who have exhausted other entitlement. In some instances, certain of these individuals may qualify for a reduced premium of $254.  You can read more about the uninsured enrollee premium here.

Concurrently, CMS also announced that the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year (CY) 2010 under Medicare’s Hospital Insurance Program (Medicare Part A). For CY 2010, these amounts are as follows:

• The inpatient hospital deductible will be $1,100.
• The daily coinsurance amounts for CY 2010 will be:

ü      $275 for the 61st through 90th day of hospitalization in a benefit period;

ü      550 for lifetime reserve days; and

ü      137.50 for the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period.

The Social Security Act (the Act) requires the subtraction of an inpatient hospital deductible and certain coinsurance amounts from the amount otherwise payable under Medicare Part A.  The coinsurance and deductible amounts are calculated based on a statutory formula.  You can review the CMS announcement of these copayment and deductible amounts here.

CMS Renews Community Health Accreditation Program Authority To Accredit Hospices

The Centers for Medicare & Medicaid Services will continue to recognize the Community Health Accreditation Program (CHAP) as a national accreditation program for hospices seeking to participate in the Medicare or Medicaid programs for the period from November 20, 2009 though November 20, 2012. CMS announced its decision to conditionally approve the continuation of CHAP’s accreditation status with a 180-day probationary period on October 23, 2009 here.

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved

Senate Finance Committee Releases Statutory Language of America’s Healthy Future Act To Present To Full Senate

Americans finally have a chance to read the actual statutory language of the painfully negotiated package of proposed health care reforms that the Senate Finance Committee proposes for adoption.  The Senate Finance Committee leadership finally finished drafting has posted the 1506 page long text of the proposed statutory language of the health care reform provisions of the ”America’s Healthy Future Act” on its website here.

When the Senate Finance Committee vote passing the America’s Health Future Act, members of the Senate Finance Committee had not yet had the opportunity to review the actual statutory language to be proposed to implement the package of heatlh care reforms painfully hashed out in their committee.  As the actual statutory language had not been completed at the time a majority of the Democrats and one Republican Senator serving on the Senate Finance Committee voted to send the legislation to the the full Senate, the vote actually was taken based on a narative description of the intended reforms set forth in a revised draft of the “Chairman’s Mark” of the legislation.  Since that time Senate Finance Committee Chairman Max Baucus and other key Democrat Senators on the Senate Finance Committee have worked behind closed doors to prepare the actual statutory language to be presented to the full Senate.

As proposed, the America’s Healthy Future Act would require sweeping changes to the U.S. health care systems that if adopted will radically impact the roles and responsibilities of every patient, health care provider, health care payor, employer and other American.  Because of the potential implications on the way health care is financed, delivered and administered and the projections that the legislation will cost approximately $1 Trillion, all parties are urged to carefully review the complex and lengthy legislation to gain an understanding of the legislation and to act quickly to make any concerns known to elected leaders in Congress. 

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.

CMS Proposes Changes To Medicare Advantage and Medicare Prescription Drug Program Rules

December 8, 2009 is the deadline for interested persons to submit comments on proposed changes to Medicare Advantage (MA) program (Part C) and prescription drug benefit program (Part D) regulations published by the Centers For Medicare & Medicaid Services (CMS) in today’s (October 22, 2009) Federal Register. If adopted as proposed, the Proposed Regulations would:

• Clarify various program participation requirements;
• Implement changes CMS intends to strengthen beneficiary protections and ensure that plan offerings to beneficiaries include meaningful differences;
• Change plan payment rules and processes; and
• Implement a new Part D formulary policy and other policy changes.

To review the Proposed Regulations or for instructions on submitting comments, see here. If you need assistance with these or other Medicare Advantage or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270 2402, cstamer@cttlegal.com, Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters. We hope that this information is useful to you. If you found this information of interest, you also may be interested in reviewing some of the following recent Solution Law Press Health Care Updates available online here. You also can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here, or e-mailing this information to cstamer@cttlegal.com, and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here. To unsubscribe, e-mail here. ©2009 Cynthia Marcotte Stamer. All rights reserved.

Forms & Instructions To Provide HITECH Act-Required Notice To OCR Of Breach of Unsecured Protected Health Information Posted

The Department of Health and Human Services (HHS) Office of Civil Rights (OCR) recently posted online forms and instructions for submitting notice of breaches of unsecured protected health information to OCR required under new protected health information breach notification rules enacted under the Health Information Technology for Economic and Clinical Health (HITECH) Act. 

Under Section 13402 of the Health Information Technology for Economic and Clinical Health (HITECH) Act as implemented by the Interim Final Breach Notification Regulations published by OCR in August, health care providers, health plans, and health care clearinghouses (covered entities) and their business associates within the meaning of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) must provide certain notifications within 60 days following discovery of a breach of unsecured protected health information to individuals whose protected health information was breached, OCR, and certain other parties. The new breach notification requirements apply to breaches occurring after September 23, 2009.

The required form to submit notice to and deadline for submitting notice to OCR depends on the number of affected individuals. For breaches affecting 500 or more individuals, notice of the breach must be submitted without unreasonable delay and no later than 60 days from the discovery of the breach. In other cases, notice to affected individuals still must be provided without unreasonable delay and within 60 days of discovery; but notification to CMS may be provided within 60 days of the end of the calendar year of discovery of the breach.

The author of this update, Curran Tomko Tarski LLP Partner Cynthia Marcotte Stamer has extensive experience advising covered entities, their business associates and others about HIPAA and other privacy and data security matters affecting covered entities and their business associates and has conducted training on the breach notification and other new HITECH Act rules and other HIPAA Privacy and Security matters.  You can review her experience, learn how to access recordings of her presentations and other details here.

Other Recent Developments

If you found this information of interest, you also may be interested in reviewing some of the following recent Solution Law Press Health Care Updates available online by clicking on the article title below:

• HIT Committee To Meet October 14 In Washington, D.C.
• Baucus Health Care Reform Proposal Calls For Significant Tightening In Tax-Exemption Rules
• Medicare Cautions Medicare-Contracted Insurance Companies & Drug Plans About Health Care Reform Advocacy Mailings As Investigation Opened Into Humana, Inc. Reform Related Communications To Beneficiaries
• CMS Proposes New Prospective Payment System For Renal Dialysis Facilities
• DEA Seeks Comments on Standardization of Code Number For Institutionally Based Practitioners Dispensing Controlled Substances
• Two Recent Criminal Prosecutions For HIPAA Privacy Rule Violations Signal Rising Criminal Enforcement Risks
• Pfizer To Pay $2.3 Billion For Fraudulent Marketing In Largest DOJ Health Care Fraud Settlement

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com, Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters. 

Ms. Stamer has extensive experience in these and other health industry related representation.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here, or e-mailing this information to cstamer@cttlegal.com, and/or by participating in the SLP Health Care Risk Management & Operations Group

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here.  To unsubscribe, e-mail here.

©2009 Cynthia Marcotte Stamer.  All rights reserved.

North Texas Healthcare Compliance Professional Association Meets October 13

October 13, 2009 Meeting Invitation/Reminder & Updated Meeting Agenda

North Texas Health Care Compliance Professional Association’s invites you to its October 13, 2009 Meeting from 2:00 – 4:00 p.m. at the Texas Health Resources Pavilion.

The first portion of the program will feature a discussion by Kristin Jenkins from DFW Hospital Council of:

• Modifications/upgrades in Group One’s Compliance Check processes; and
• The ability to use the Data Initiative to pull RAC specific indicators and a dashboard in development for Compliance Officer use.

The second portion of the program will be a participatory Health Care Compliance Roundtable Discussion of Hot Topics moderated by the Erma E. Lee, JPS Health Network District Compliance Officer and NTPCA President. Topics to be discussed include:

• HIPAA Data Breach;
• Red Flag & Other Evolving Privacy & Data Security Obligations & Risks;
• Office of Civil Rights Health Industry Disability & Other Civil Rights Enforcement;
• Tax-Exemption Issues Including Proposed Form 990 and Exemption Reforms In Health Care Reform;
• Health Care Fraud Enforcement; and 
• Other Hot Developments

NTHCPA invites interested persons to come catch up on these and other new developments and exchange thoughts and insights with other Health Care Compliance Professionals on Tuesday, October 13, 2009 from 2:00 – 4:00 p.m. in Classroom B of the Texas Health Resources Pavilion located at 612 E. Lamar Blvd., Arlington, TX. NTHCPA thanks Texas Health Resources for hosting this month’s meeting. For additional information, please contact NTHCPA Vice-President Cynthia Marcotte Stamer at (214) 270-2402 or by e-mail at cstamer@solutionslawyer.net. NTHCPA looks forward to seeing you there! About the NTHCPA NTHCPA exists to champion ethical practice and compliance standards and to provide the necessary resources for ethics and compliance Professionals and others in North Texas who share these principles. The vision of NTHCPA is to be a pre-eminent compliance and ethics group promoting lasting success and integrity of organizations within North Texas. To register or update your registration or to receive notice of future meetings, e-mail here . This communication may be considered a marketing communication for certain purposes. If you wish to update your e-mail for purposes of or would prefer not to receive future e-mail concerning meetings or other activities of the North Texas Healthcare Compliance Professionals Association or other marketing and promotional mailings from it, please send an email with the word “unsubscribe” in its subject heading to here.

North Texas Healthcare Compliance Association Meets October 13 at 2 p.m.

October 13, 2009 Meeting Invitation/Reminder & Updated Meeting Agenda

North Texas Health Care Compliance Professional Association’s invites you to join us for our October 13, 2009 Meeting from 2:00 – 4:00 p.m. at the Texas Health Resources Pavilion. 

The first portion of the program will feature a discussion by Kristin Jenkins from DFW Hospital Council of:

• Modifications/upgrades in Group One’s Compliance Check processes;
• The ability to use the Data Initiative to pull RAC specific indicators and a dashboard in development for Compliance Officer use; and

 The second portion of the program will be a participatory Health Care Compliance Roundtable Discussion of Hot Topics moderated by the Erma E. Lee, JPS Health Network District Compliance Officer and NTPCA President. Topics to be discussed include:

• HIPAA Data Breach, Red Flag & Other Evolving Privacy & Data Security Obligations & Risks
• Office of Civil Rights Health Industry Disability & Other Civil Rights Enforcement
• Tax-Exemption Issues Including Proposed Form 990 and Exemption Reforms In Health Care Reform
• Health Care Fraud Enforcement
• Other Hot Developments

 NTHCPA invites interested persons to come catch up on these and other new developments and exchange thoughts and insights with other Health Care Compliance Professionals on Tuesday, October 13, 2009 from 2:00 – 4:00 p.m. in Classroom B of the Texas Health Resources Pavilion located at 612 E. Lamar Blvd., Arlington, TX. 

NTHCPA thanks Texas Health Resources for hosting this month’s meeting.  For additional information, please contact NTHCPA Vice-President Cynthia Marcotte Stamer at (214) 270-2402 or by e-mail at cstamer@solutionslawyer.net.

NTHCPA looks forward to seeing you there!

About the NTHCPA

NTHCPA exists to champion ethical practice and compliance standards and to provide the necessary resources for ethics and compliance Professionals and others in North Texas who share these principles.

The vision of NTHCPA is to be a pre-eminent compliance and ethics group promoting lasting success and integrity of organizations within North Texas.

To register or update your registration or to receive notice of future meetings, e-mail here .

This communication may be considered a marketing communication for certain purposes.  If you wish to update your e-mail for purposes of or would prefer not to receive future e-mail concerning meetings or other activities of the North Texas Healthcare Compliance Professionals Association or other marketing and promotional mailings from it, please send an email with the word “unsubscribe” in its subject heading to here.

North Texas Healthcare Compliance Professional Association To Meet At Texas Health Resources On October 13

NORTH TEXAS HEALTHCARE COMPLIANCE PROFESSIONAL ASSOCIATION

October 13, 2009 Meeting Reminder

2:00 – 4:00 p.m. at the Texas Health Resources Pavilion

North Texas Health Care Compliance Professional Association’s October 13, 2009 Meeting will feature a participatory Health Care Compliance Roundtable Discussion of Hot Topics moderated by the Erma E. Lee,  JPS Health Network District Compliance Officer and NTPCA President on Tuesday, October 13, 2009 from 2:00 – 4:00 p.m at the Texas Health Resources Pavilion located at 612 E. Lamar Blvd., Arlington, TX.  Topics to be discussed include:

•  HIPAA Data Breach, Red Flag & Other Evolving Privacy & Data Security Obligations & Risks
•   Office of Civil Rights Health Industry Disability & Other Civil Rights Enforcement
• Tax-Exemption Issues Including Proposed Form 990 and Exemption Reforms In Health Care Reform
• Health Care Fraud Enforcement
• Other Hot Developments

Come catch up on these and other new developments and exchange thoughts and insights with other Health Care Compliance Professionals!                       

NTHCPA thanks Texas Health Resources for hosting this month’s meeting.

For additional information, please contact NTHCPA Vice-President Cynthia Marcotte Stamer at (214) 270-2402 or by e-mail at cstamer@solutionslawyer.net.

 We look forward to seeing you there!

About the NTHCPA

NTHCPA exists to champion ethical practice and compliance standards and to provide the necessary resources for ethics and compliance Professionals and others in North Texas who share these principles.

The vision of NTHCPA is to be a pre-eminent compliance and ethics group promoting lasting success and integrity of organizations within North Texas.

To register or update your registration or to receive notice of future meetings, e-mail here .

This communication may be considered a marketing communication for certain purposes.  If you wish to update your e-mail for purposes of or would prefer not to receive future e-mail concerning meetings or other activities of the North Texas Healthcare Compliance Professionals Association or other marketing and promotional mailings from it, please send an email with the word “unsubscribe” in its subject heading to here.