The Joint Commission (not-for-profit organization that accredits health care organizations) recently published a Sentinel Event Alert discussing healthcare worker fatigue and patient safety.  We can all think about a personal experience where fatigue has impacted one or more of our performance behaviors resulting from insufficient quality or inadequate sleep.  Research clearly documents mental overexertion can lead» Read Full Article

R&R Insurance announces the date for the new Cyber Liability seminar, which will cover how a business can protect itself against cyber crime, will be Wednesday, October 5, 2011, 8:00am – 11:30am, held at the MRA conference Center in Waukesha, WI. Companies receive an average of 4 million attacks against their networks on a daily» Read Full Article

In 2009, medicare reclaimed $2.51 billion from physicians and other health-care providers which is a 29% increase over the prior year. Over $441 million in federal medicare money was returned in 2009 which was a 29% increase over 2008. R&R Insurance offers protection for your practice and reputation with FFActs Regulatory Compliance Insurance. Coverage Includes: Protection from Alleged» Read Full Article

A four-physician cardiology group in Mississippi was targeted by the Center for Medicare Services (CMS). After an initial review of 159 claims, CMS determined that 30 were improperly paid. Based on the error rate, CMS demanded more than $2.4 million be repaid to the Medicare program within 30 days. Fortunately, the group had purchased the» Read Full Article

Rules governing the restricted use of patient information create an additional liability exposure for the healthcare industry. The final HIPAA regulations establish the first ever national standards for privacy of health information. Enforcement activity for non-compliance may become an additional challenge for hospitals that are governed by these regulations in the near future.  R&R Insurance offers coverage» Read Full Article

Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractor (RACs) conduct automated reviews of Medicare payments to health care providers—using computer software to detect improper payments. RACs also conduct complex reviews of provider payments—using human review of medical records and other medical documentation to identify improper payments to providers. Improper payments include: incorrect payment» Read Full Article

Patient referral relationships and financial incentive arrangements between hospitals and other healthcare services could be found in violation of the current STARK regulations (Non-Compliant Referral Agreements). Hospital contracts, leases and other side agreements are now under intense scrutiny and could prove costly to hospital practices for unintentional violations. Understanding the laws governing referral relationships is» Read Full Article

This group paid $611,250 to resolve their liability under the Civil Monetary Penalties (CMP) applicable to kickbacks and physicians self-referrals. They did not have regulatory insurance and were responsible for the entire fine. More Civil Monetary Penalty Claims For more information about Regulatory Compliance Insurance, contact knowledgebroker Carla Borda at 262-953-7138. Carla Borda is R&R Insurance’s» Read Full Article

A Fairfield, New Jersey physician (now retired) paid $40,000 to resolve his liability under the Civil Monetary penalties provisions applicable to false claims and kickbacks. He did not have regulatory insurance and had to absorb the full cost. More Civil Monetary Penalty Claims For more information about Civil Monetary penalties or Regulatory Compliance Insurance, contact» Read Full Article

Accountable Care Organizations, or ACOs, are certainly the buzz word in healthcare.  If you are a healthcare provider and serve at least 5000 medicare patients, you are either thinking about, talking about, or considering joining an ACO.  In preparing for a recent presentation at the WMGMA on this topic, I had to wonder how this» Read Full Article