Insights

How to be Secure with Your Privacy and Security Program

Over the past year, reports of Protected Health Information (PHI) breaches, ransomware attacks and hacking of healthcare software systems/applications have increased. Due to the uptick in potential breaches and threats to PHI, the Office of Civil Rights (OCR) has also increased its efforts to ensure healthcare organizations have the appropriate...

Are you monitoring the right data? What HIM directors should be looking for.

The Health Information Management (“HIM”) department is the informational and financial hub of healthcare facilities. Coders, clinical documentation specialists (“CDS”) and quality/compliance analysts are the last line in an important workflow that determines a facility’s reimbursement.  An HIM directors’ responsibilities go beyond making sure things just run smoothly.  A successful...

Mobile Healthcare IT Adoption: Securing Physician Engagement

Mobile Healthcare IT Adoption: Strategies to Secure Physician Engagement According to the 2016 Red Hat survey, investment in mobile applications by healthcare organizations are paying off, with 78% of organizations surveyed reporting a positive return on their investment.   With these positive returns, adoption of mobile healthcare applications is only expected...

The Impact of Escobar on FCA Healthcare Cases

Recently, the Supreme Court (“the Court”) considered whether whistle-blowers and the government should be allowed to bring False Claims Act (“FCA”, “the Act”) cases under the implied false certification theory. In a unanimous decision in Universal Health Services, Inc. v. United States ex rel. Escobar et al. (“Escobar”) issued on...

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...

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...

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...

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...

About Us

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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