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Home Health & Hospice Week

Industry Notes:

HIPAA ENFORCEMETN MAY GET TOUGHER

Published on Mon Mar 21, 2005

HHS proposes civil monetary penalties for all HIPAA infractions.

Get HIPAA-compliant or get smacked with civil money penalties, says the Department of Health and Human Services.

HHS issued a proposed Health Insurance Portability and Accountability Act enforcement rule in the April 18 Federal Register. Existing HIPAA enforcement relies heavily on voluntary compliance. If violations aren't resolved informally, HHS will issue CMPs.

Now HHS wants to streamline CMPs and enforcement to bring together and adopt CMP implementation rules for all HIPAA rule violations. The proposed rule addresses determining violations, calculating CMPs, procedures for court hearings and the statutory limitations in enforcing CMPs.

The proposed new subpart D, "Imposition of Civil Money Penalties," allows up to a $100 penalty per violation and up to $25,000 for identical violations within one calendar year. However, you can receive separate CMPs for violating the security and privacy rules in the same occurrence. You can also receive multiple penalties for multiple violations of the same requirement.

Hidden trap: The proposed rule provides that you could be held liable for CMPs imposed on an affiliated covered entity.

The proposed enforcement rule is at www.access.gpo.gov/su_docs/fedreg/a050418c.html under "Health and Human Services." 

  • The Centers for Medicare & Medicaid Services official responsible for the national wheelchair coverage criteria process is in hot water over false record charges.

    CMS chief medical officer Sean Tunis was placed on administrative leave with pay earlier this month after a state medical board accused him of lying about his credentials, according to press reports. The Maryland Board of Physicians on Feb. 23 formally charged him with falsifying documents relating to his continuing medical education requirements. Tunis works as a part-time emergency physician at a Baltimore hospital.

    In his defense, Tunis says he merely attempted to reproduce lost records of CME credits and blames a disgruntled CMS employee for making false accusations against him. An administrative law judge will hear the case in July. Barry Straube, chief medical officer for CMS Region IX in San Francisco, is temporarily filling in for Tunis.
     
  • The U.S. District Court for the Western District of Louisiana has shot down Aging Care Home Health Inc.'s request for an injunction against a Medicare payment suspension. After a whistleblower suit accusing the Monroe, LA agency of medical director kickbacks was unsealed earlier this year (see Eli's HCW, Vol. XIV, No. 6), intermediary Palmetto GBA suspended Medicare payments to the HHA, according to a ruling on the injunction filed March 31.

    The Court denied a request for a temporary restraining order in February, and now has denied Aging Care's request for a preliminary injunction against the suspension. The Court doesn't have jurisdiction over the suspension because the agency hasn't exhausted its administrative remedies with Medicare, the ruling says.

    While the intermediary can suspend payments without appeal for up to two 180-day periods, after that it must deny or approve the claims at issue. If denied, the HHA then can appeal, the Court explained.
     
  • Vermont may pass a law clarifying and strengthening its certificate of need (CON) process and the 12 HHAs who serve under it, reports the Associated Press. But the move could bring heavier regulatory requirements on the agencies, one lawmaker warns.

    Representatives for the HHAs testified in favor of the legislation at an April 14 hearing, while a lobbyist for the agency trying to crack into the CON system testified against it. All sides agree the bill is aimed at ending the current Department of Justice probe against the agencies for anti-trust practices (see Eli's HCW, Vol. XIII, No. 43). A state panel recently recommended loosening CON requirements.
     
  • Lower Medicare reimbursement knocked the wind out of Clearwater, FL-based Lincare Holdings Inc. in the first quarter of this year.

    The oxygen provider earned $54.6 million on revenues of $305.2 million for the quarter ended March 31. That's down 13 percent from the same period a year ago, when Lincare earned $62.9 million on revenues of $306.9 million.

    The company blamed the decline on reductions in Medicare reimbursement for respiratory medications and certain durable medical equipment that took effect on Jan. 1. Lincare estimates the changes reduced its operating income in the quarter by $43 million.
     
  • A company that has developed a "talking" pill bottle has announced its pending acquisition of one HHA, and it plans to buy up to 11 more. Pittsburgh-based Wizzard Software plans to purchase Casper-based Interim Health Care of Wyoming and operate the agency under its MedivoxRx Technologies subsidiary.

    In addition to increasing home health patients' use of speech recognition products like the talking blood pressure monitors and medication reminders, the company wants to develop and sell HHA Medicare forms that use speech recognition or text-to-speech, Wizzard says in a release.     
     
  • St. Louis-based VNA-TIP unit VNA PrivateCare has purchased St. Charles, MO-based Doctor's Preferred Home Health Care, reports the St. Louis Business Journal. Another VNA-TIP unit, TIP HealthCare, acquired Doctor's Preferred vaccination business, the paper says. VNA-TIP will retain all of Doctor's Preferred HHA staff, it says.
     
  • Matria Healthcare Inc. has been awarded four new disease management accounts and expanded programs and services for two of its current DM clients, the Marietta, GA-based DM company reports. That's in addition to six new awards announced in February.
     
  • Arcadia Resources Inc. has boosted its presence in Southwest Florida. The Southfield, MI-based DME provider through its Beacon Respiratory Services Inc. subsidiary has announced that it acquired the assets of United Health Care Services Inc.

    United is a DME supplier focused on respiratory disease management with operations in Ft. Myers and Port Charlotte, FL. After the acquisition is completed, Beacon will operate the business under the Arcadia H.O.M.E. name.
     
  • National Home Health Care Corp. has agreed to acquire certain assets from Helping Hands Health Care, a subsidiary of New York Health Care Inc. An NHHC subsidiary, Accredited Health Services Inc. in New Jersey, will acquire the licensed home care provider with annual revenues of $6.7 million, Scarsdale, NY-based NHHC and New York City-based NYHC say in their releases.

    NHHC will pay $3 million for the acquisition, NYHC says.     
     
  • Authorities raided the offices of The Scooter Superstore in Lincoln, NE - but they're not saying exactly why. Earlier this month, the Federal Bureau of Investigation carried out a search warrant at the business, the Lincoln Journal Star reports.
     
    Investigators would say only that they were looking for documents as part of a joint investigation with the Internal Revenue Service and Nebraska's Health and Human Services System.

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