HHS wants in excess of a billion dollars to combat Medicare fraud next year.
Look for more fraud patrol efforts coming from the nation's capital.
On July 18, Department of Health and Human Services Secretary Mike Leavitt told the House budget committee that the Bush administration would seek additional funding for fiscal year 2008 to combat Medicare fraud--to the tune of $1.3 billion for that year alone.
The goal is to secure funding for a program jointly operated by HHS and the Department of Justice to coordinate federal, state and local law enforcement efforts to reduce fraud in Medicare.
In a new move, HHS said that the administration hopes to revise current law to allow some of the funds recovered in fraud investigations to go toward efforts to address fraud. Current law directs that all funds recovered in fraud investigations go back to the Medicare trust fund. • You'd better make sure your HIPAA policies and procedures are up to snuff. The feds may be getting more serious about investigating potential HIPAA violations.
In addition to the HHS Office of Inspector General conducting its first HIPAA security rule audit this spring (see Eli's HCW, Vol. XVI, No. 15), the Department of Health and Human Services has granted subpoena power to the HHS Office for Civil Rights. OCR is in charge of HIPAA enforcement.
The authority covers "subpoenas in investigations of alleged violations of the HIPAA Privacy Rule and of the Patient Safety and Quality Improvement Act of 2005," the HHS OCR Web site notes. • Provider enrollment may get even more arduous thanks to a new transmittal.
Providers have 60 days to respond to a pre-screening letter requesting information and documentation. "If the contractor makes a follow-up request for information, the 60-day clock does not start anew," the Centers for Medicare & Medicaid Services emphasizes in June 29 Transmittal No. 214 (CR 5504).
"Rather, it keeps running from the date the pre-screening letter was sent." The contractor can, at its discretion, extend the time clock if the provider is working toward compliance, CMS adds.
Supplier revocations fast-tracked: Revocations issued by a contractor other than the National Supplier Clearinghouse become effective within 30 days of the initial revocation notification, CMS says. NSC revocations are effective 15 days after the entity is sent notice of the revocation.
Program Safeguard Contractors and CMS satellite and regional offices can initiate revocations by going through the Division of Provider and Supplier Enrollment, the transmittal adds. You can read the transmittal online at
www.cms.hhs.gov/transmittals/downloads/R214PI.pdf. • There's a good reason you're struggling so hard with emergent care outcomes. A recent study found older adults have an emergency medical services utilization rate four times that of younger patients.
According to a study published in [...]
