BMN Blog

OCT 23

There is a lot of confusion about SSDI and SSI, the two types of disability benefits that can be received from Social Security. The definition of disability is the same under both programs, but that is where the similarity ends. The following is a very basic description of the disability programs provided under the Social Security Act, titles II and XVI.

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OCT 12
ARE YOU PREPARED FOR YOUR BUSINESS ASSOCIATE’S HIPAA BREACH? By Beth Pitman, JD, CHPC, Waller, Lansden, Dortch & Davis LLP in Regulatory

  As of September 30, 2017, the Department of Health and Human Services Office of Civil Rights (OCR) has received notices of 237 breaches. 46% occurred as result of hacking or IT security incidents; many at the business associate level.  Ransomware is rampant and projected to increase 670%.  As a covered entity, although a breach occurs at your business associate, under HIPAA, you are responsible for your protected health information and responding to the breach.  OCR has been clear that breaches of 500 or more records will be investigated. Given the significant increase in breaches over the past few years, advance preparation is critical and can reduce the cost and burden of breach response. 

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OCT 10
Billing Under Another’s Provider Number Can Land Physicians in Hot Water By Emma Cecil, JD, Senior Regulatory Attorney & PolicyHolder Advisor with MagMutual in Regulatory

An Oklahoma physician agreed on August 28, 2017 to pay the government $580,000 to resolve allegations that he violated the False Claims Act by submitting claims to the Medicare program for services he did not provide or supervise. According to the government, the physician allowed a company that employed him and in which he had an ownership interest to use his NPI numbers to bill Medicare for physical therapy evaluation and management services that he did not provide or supervise. The government further alleged that after he separated from the company and deactivated his NPIs associated with the company, he reactivated those NPIs so that the company could use them to bill Medicare for services he neither performed nor supervised.

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JUL 05
MACRA Quality Payment Program Year 2 Proposed Rule By Beth Pitman, CHPC, Counsel at Waller, Lansden, Dortch & Davis, LLP in Regulatory

On June 20th, CMS issued its proposed rule for year 2 of the Quality Payment Program (QPP) under Medicare Access and CHIP Reauthorization Act of 2015( MACRA).  Comment period ends August 20. 

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MAY 17
The Merit Based Incentive Program- Small Practices-Big Decisions By Tammie Lunceford, CPC Healthcare Consultant, Warren Averett in Business

As we approach the beginning of summer, our minds are likely not on summer vacation. The process of assessing our electronic medical record vendor, absorbing the details of MIPS, and making the decisions on how to prepare, is overwhelming for small practices.  The transition to value based medicine has been evolving over the last 10 years in stages; adopting electronic health record, Quality Reporting, and Meaningful Use.  Many administrators and physicians did not realize the importance of each project; from choosing the right EMR, to implementing it properly, therefore achieving best practice workflows.

 

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MAY 04
OVER SIXTY YEARS OLD AND STILL MISUNDERSTOOD By : Janet Cox , Attorney at law with Cox Disability Law in Regulatory

Social Security Disability under Title II of the Social Security Act*

Surveys have shown that most Americans know little about Social Security law and the vital benefits it provides. By far, the least understood Social Security benefit is Social Security Disability Insurance (SSDI). This lack of knowledge has been measured through objective testing in various academic studies. Anecdotally, I know this to be true based on recurring questions and comments I have received from the public and clients alike over the last several decades of my work as a social security disability attorney.

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MAR 27
Adding a Mid-Level Provider? Pitfalls to Avoid By Tammie Lunceford, CPC Healthcare Consultant, Warren Averett in Clinical

In the last 10-15 years, the use of mid-level providers has increased to expand the base of patients in many practices.  The Nurse Practitioner scope of practice is more flexible and there are specialty designations available to foster expertise in certain areas.  The insurance companies have expanded the number of plans covering a mid-level provider’s services.

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