What is it? In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The passage of this law repealed the Medicare sustainable growth rate (SGR) formula that calculated payment cuts for physicians, and replaced it with new measures that combine several existing quality reporting programs into...
HIPAA Enforcement: Administrative Law Judge Rules in Favor of OCR Enforcement
“Under HIPAA, Respondent was obligated to take reasonable steps to protect its PHI from theft.” On January 13, 2016, an Administrative Law Judge (“ALJ”) ruled that Lincare, Inc. (“Lincare”), a home health company, violated the HIPAA Privacy Rule. Lincare was ordered to pay $239,800 in civil money penalties (“CMPs”) imposed...
HHS Releases Final Rule Regarding Mandatory Reporting of Overpayments
“Thus, we believe our final rule does not create additional burden or cost on providers and suppliers in this regard” On February 12, 2016, the Department of Health and Human Services published the final rule on the reporting and returning of self-identified Medicare overpayments. §6402(d) of the Affordable Care Act...
CMS Adopts Standardized Set of Quality Measures
“In the U.S. healthcare system, where we are moving to measure and pay for quality, patients and care providers deserve a uniform approach to measure quality” On February 16, 2016 CMS and American’s Health Insurance Plan announced the release of seven (7) sets of clinical quality measures to be used...
Supreme Court Case Regarding False Claims Act Could Have Major Implications for the Healthcare Industry
“The American Medical Association argues in its brief that imperfect compliance is not the same as fraud” Healthcare organizations across the Country, including the American Medical Association, are joining the Supreme Court case Universal Health Services v. United States ex rel Escobar, the outcome of which could heavily impact the...
DocEdge™ Communicator Dramatically Reduces Physician Response Times
Clients are experiencing immediate and significant improvements in response rate, response time and agreement rates after implementing DocEdge™ Communicator to manage the referral and query process. Results from a recent implementation: Physician Response Times reduced from over 24 hours to 4 hours 85% of Physician Responses received within 3 hours...
Provident Consulting Announces Formation of Strategic Advisory Board
Provident Consulting, a leader in Technology Enabled Clinical Solutions™, announced the appointment of leading experts from across the healthcare industry to its newly formed Strategic Advisory Board. The Strategic Advisory Board will work with Provident’s leadership team as Provident Consulting continues to scale its suite of Technology-Enabled Clinical Solutions ™...
Provident Consulting CEO Featured in Finance Monthly
Press Release Provident Consulting, a leading Healthcare Clinical and Finical Performance Improvement firm, is honored to announce that Michael Dougherty, CEO, is featured in the June issue of Finance Monthly. Detroit, MI – June 22, 2015 – Provident Consulting, a leading Healthcare Clinical and Financial Performance Improvement firm, announced that...
Show Me the Record: The Importance of Good Clinical Documentation
ICD-10, Meaningful Use and integrity/quality initiatives have recognized the need for and contributed to the impetus for improved clinical documentation. Good clinical documentation is a critical element in delivering patient care. Complete and accurate documentation validates the care provided shares key data with subsequent caregivers and allows coders to code...
Provident Consulting announces DocEdge™ Communicator
Press Release Provident Consulting announces DocEdge™ Communicator Provident, a leader in healthcare management consulting and compliance solutions, announces the release of DocEdge™ Communicator, a HIPAA compliant cloud based app technology that allows for efficient and effective communication between Case Managers, Clinical Documentation Specialists, Physician Advisors and Attending Physicians. Detroit, MI...