Compliancy Group

Unveiling the Dark Side of Dentistry: Worcester Dental Office Manager’s Shocking Role in Medicaid Fraud Scheme

In a shocking turn of events, a dental office manager from Worcester has been sentenced for participating in a scheme to defraud the Massachusetts Medicaid program, MassHealth. Robin Cronin, 61, was handed down a sentence of two years probation by U.S. Senior District Court Judge Timothy S. Hilman.  September of 2020 marked the month when Cronin, burdened by guilt, reluctantly admitted to [...]

2023-08-30T15:18:19-04:00August 23rd, 2023|
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Staying Clear of the Medicare Exclusion List

In the current labor market, the demand for qualified healthcare employees is skyrocketing. But nearly 74,000 people in the U.S. are missing out on most of these opportunities because their names are on the HHS OIG (Health and Human Services, Office of Inspector General) Medicare Exclusion List. Many people have never heard of this list, and what's worse is that some people [...]

2023-07-25T10:22:03-04:00March 8th, 2023|
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MIPS and MACRA 2022: What’s New?

In 2015, legislation known as the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted. Until the passage of the CURES Act in 2016, MACRA was the most significant legislative overhaul of the U.S. healthcare system since 2010’s Affordable Care Act. Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers' use of health information technology. One of these incentives is the [...]

2023-09-19T13:06:04-04:00November 16th, 2022|
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Why You Should Complete an SRA Now Even If You Qualify for a MIPS Exception

CMS recently announced that under certain circumstances, healthcare providers are exempt from the requirement to complete a security risk analysis (SRA), while remaining eligible to benefit from the MIPS Quality Payment Program. However, healthcare providers must still complete an SRA to satisfy HIPAA requirements. So even if you qualify for the MIPS SRA exemption, you will still need to meet the HIPAA SRA requirement. Why you should complete [...]

2023-07-31T15:07:23-04:00October 19th, 2020|
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What are Telehealth Laws By State?

As the COVID-19 pandemic continues, states have implemented regulatory changes related to telehealth. Telehealth and telemedicine laws by state are discussed below. Telehealth Laws by State: Medicaid Populations The federal Medicaid program has affected telehealth laws by state. Medicaid gives states broad authority to permit coverage for telehealth services. Before the COVID-19 emergency, many states had already implemented broad telehealth coverage. Since March of 2020, [...]

2023-07-31T15:13:25-04:00October 6th, 2020|
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What is Health Information Blocking?

Recently, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on electronic protected health information (ePHI) sharing. The rule is scheduled to become effective by 2021. The rule contains provisions designed to discourage the practice of health information blocking. Health information blocking is information or data blocking that occurs when healthcare providers or IT vendors deliberately and unreasonably interfere with the exchange [...]

2023-08-01T09:11:44-04:00May 19th, 2020|
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HIPAA Security Risk Analysis Step 6: Determining the Level of Risk to ePHI

The HIPAA Security Rule requires that covered entities (health plans, healthcare clearinghouses, and healthcare providers who electronically transmit any health information in connection with a HIPAA related transaction), and business associates, implement security safeguards. These security safeguards must protect the confidentiality, integrity, and availability of electronic protected health information (ePHI). ePHI is any protected health information that is created, stored, transmitted, or received in any [...]

2023-08-07T15:08:50-04:00September 23rd, 2019|
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HIPAA Security Risk Analysis Step 5: Determining the Potential Impact of Threat Occurrence

The HIPAA Security Rule requires that covered entities (health plans, healthcare clearinghouses, and healthcare providers who electronically transmit any health information in connection with a HIPAA related transaction), and business associates, implement security safeguards. These security safeguards must protect the confidentiality, integrity, and availability of electronic protected health information (ePHI). ePHI is any protected health information that is created, stored, transmitted, or received in any electronic format. Performing [...]

2023-08-07T15:16:45-04:00September 17th, 2019|
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What is MACRA?

MACRA, short for the Medicare Access and CHIP Reauthorization Act of 2015, is a federal law that changed the payment system for doctors who treat Medicare patients.  What is the MACRA Quality Payment Program? MACRA, commonly referred to as the Permanent Doc Fix, created a Quality Payment Program that: Repealed the Sustainable Growth Rate (SGR) formula. That formula had previously been used by the Centers [...]

2023-09-19T13:07:29-04:00September 16th, 2019|
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HIPAA Security Risk Analysis Step 4: Determining the Likelihood of Threat Occurrence

The HIPAA Security Rule requires that covered entities (health plans, healthcare clearinghouses, and healthcare providers who electronically transmit any health information in connection with a HIPAA related transaction), and business associates, implement security safeguards. These security safeguards must protect the confidentiality, integrity, and availability of electronic protected health information (ePHI). ePHI is any protected health information that is created, stored, transmitted, or received in any [...]

2023-08-07T15:27:36-04:00September 10th, 2019|
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