On June 18, 2018, the Office for Civil Rights issued new guidance on HIPAA and individual authorization of uses and disclosures of protected health information (PHI) for research. The guidance explains certain requirements for an authorization to use or disclose PHI for future research and clarifies aspects of the individual's right to revoke an authorization for research uses and disclosures of PH

Measuring compliance program effectiveness is recommended by several authorities, including the United States Sentencing Commission (see, Chapter 8 of the United States Sentencing Guidelines). The Compliance Department is not permitted to perform these audits. Audits must be performed independently, to avoid self-policing. https://www.cms.gov/Medicare/Compliance-and-Audits/Part-C-and-Part-D-Compliance-and-Audits/Downloads/Element-VI-Focused-Training-Power-Point-.pdf. However, it has been reported that only 25 percent of surveyed organizations reported using outside experts to evaluate their program, and nearly 66 percent of organizations claimed that they rely upon self-assessment tools and checklists to evidence their compliance program effectiveness.

On February 9, 2018, Congress enacted a permanent solution to the hard cap on outpatient therapy services under Medicare Part B, ending a cycle of short-term fixes that have been necessary since its introduction in 1997 as part of the Balanced Budget Act.

The legislation that has been enacted provides a fix for the therapy cap by permanently extending the current exceptions process. Among the provisions included in the new policy:

On February 2, 2018, CMS issued Transmittal 3971 revising Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section 100.1.1, B, that allows the teaching physician to verify in the medical record any student documentation of components of evaluation and management (E/M) services, rather than redocumenting the work. The policy change applies to all students who teaching physicians supervise, including advance practice professionals. The revised policy reads as follows:

My comments follow and generally address the legal and compliance considerations associated w/ the set aside of a jury verdict for $347M due to FCA violations determined by a jury related to the absence of nursing home care. These views were generally addressed in an interview by me appearing in the Report on Medicare Compliance, V. 27, #3, Jan. 22, 2018. See (United States ex rel. Ruckh v Salus Rehabilitation, LLC, 2018 US Dist LEXIS 5148 [MD Fla Jan. 11, 2018, No. 8:11-cv-1303-T-23TBM].) The case was filed in 2011. DOJ declined intervention. The case commenced trial on Jan 17, 2017 w/ a jury verdict returned on February 15, 2017.