Author Archives: Brenda Palumbo

Elements of a HIPAA Business Associate Agreement

Business Associate Agreements:  Required Elements The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), Public Law 104-191, requires covered entities (“CEs”) and business associates (BAs) to execute a business associate agreement (“BAA”) with their business associates (subcontractors) to ensure that the BA agrees to comply with the Privacy and...

Top 7 Changes Coders and Physicians Need to Know About

FY 2017 IPPS and 2016 Coding Clinic – Top 7 Changes Coders and Physicians Need to Know About The 4th Quarter 2016 Coding Clinic and 2017 Inpatient Prospective Payment System (IPPS) final rule includes the most significant changes since the partial code freeze began on October 1st 2012. Below is...

RANSOMWARE: REAL THREATS, STEEP FINES

The healthcare industry has been no stranger to cyber and ransomware attacks. With increased threats and an uptick in Office for Civil Rights (OCR) enforcement as a result of those threats, organizations of all sizes should 1) evaluate their susceptibility to attacks, 2) employ processes and software to prevent attacks...

The 2017 OIG Work Plan: What You Need to Know

The Health and Human Services (“HHS”) Office of Inspector General (“OIG) released the 2017 Work Plan (“Work Plan”) outlining its priorities for new and ongoing audits and evaluations for the current and coming year. The OIG Work Plan also provides an update on items that have been completed, postponed or...

Focus Areas for Compliance Officers in 2017

Compliance Officers have a myriad of risks to address. At Provident, we believe the following challenges should be prioritized for 2017 and included in healthcare Compliance Officer’s Compliance Work Plan: Quality Payment Program and other alternative payment models – With the rollout of MACRA, alternative payment models and bundles, compliance...

The Importance of a Business Associate Agreement

Two recent settlements by the Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) illustrate the importance of executing a business associate agreement (“BAA”). The first was on March 16, 2016 when OCR announced a $1.55 million settlement with a not-for-profit healthcare system in Minnesota for failing to enter...

MACRA HAS BEEN FINALIZED: What you need to know

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rule has been finalized.  Since publishing the proposed rule, CMS has addressed thousands of comments, created an easy to follow ‘what is MACRA’ website and released a 24 page executive summary of the final rule.  Whether you have been keeping...

ICD-10 DRG Driven Shifts: COPD with Asthma Exacerbation

Through our work conducting DRG audits, Provident has identified a number of new shifts due to the change from the ICD-9 to ICD-10 codeset. Many of these DRG shifts were due to changes in the Official Coding Guidelines, Indexing, and procedure coding. Below is an example of one of the...

New Hypertension Codes Released

October 2016 ICD-10 Code Update: New Hypertension Codes Released New hypertension codes for hypertensive urgency (I16.0), hypertensive emergency (I16.1), and hypertensive crisis, unspecified (I16.9) went into effect for discharges starting October 1st. According to Coding Clinic, “The American Academy of Pediatrics requested detailed codes to track patients who present with...

Healthcare Technology Solutions: What Doctors Want

A survey recently conducted by the AMA found that doctors are most interested in utilizing technology that helps to improve patient care and safety and enhance physician efficiency.  Of the 1,300 physicians surveyed, a majority also indicated that new technology solutions must interface with the EMR and ensure data privacy...

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Leveraging our deep operational experience and real world understanding of the regulatory landscape, Provident partners with our clients to meet the diverse challenges of the evolving healthcare industry. With proven solutions, expertise, innovative thinking, and specialized tools and techniques the Provident team works collaboratively with clients to optimize their financial and operational performance.

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