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Medicare Revises E/M Service Documentation Provided by Students

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:

Robert Trusiak Discusses Compliance Requirements After Escobar, Ruckh And The Set Aside Of $347M False Claims Act Jury Award

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.

SAMHSA Issues Final Rule Updating Substance Abuse Confidentiality Regulations

The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services (HHS), has finalized proposed changes to the Confidentiality of Substance Use Disorder Patient Records regulation, 42 CFR Part 2, aimed at supporting payment and healthcare operations activities while protecting the confidentiality of patients.

2018 Compliance Plan Work

First and foremost, initially look backward before looking forward and look inward before looking outward and always be mindful of the goal of any work plan.

The goal of a work plan is twofold: the obvious goal of addressing risk areas to advance fraud and abuse and HIPAA compliance as well as providing a credible narrative to regulatory and law enforcement authorities of the provider's demonstrated commitment to compliance evidenced by audits and remittances, as appropriate.

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