Rx2000HIPAA Digest, Volume 7 > > #1 From: NBorho@ascensionhealth.org Subject: RE: MSO/IPA a health plan > #2 From: mw.davis@baylordallas.edu Subject: RE: medicare fraud > #3 From: Albert-Oriol@smh.com Subject: RE: Job Descriptions, Other Requests > #4 From: renae.heisler@hhss.state.ne.us Subject: CLIA - HIPAA > #5 From: henrybasset@chesapeake.net Subject: Re: Job Descriptions, Other Requests > #6 From: Albert-Oriol@smh.com Subject: RE: Job Descriptions, Other Requests > #7 From: hipadmin@rx2000.org Subject: Rx2000 SIG > #8 From: hipadmin@rx2000.org Subject: SIG Meeting Confimations > > > ********** Message #1 ********** > From: NBorho@ascensionhealth.org > To: > Subject: RE: MSO/IPA a health plan > Date: Thu, 30 Mar 2000 20:53:06 -0600 > > Sara I can't speek for the status of our Home Care program, however, I do = > believe that there must be more than just our two organizations who might = > want to get together to share info, problems & solutions. Please reply = > direct to me and I'll put you in direct contact with the person in charge = > of our systems Home Care operations - once you all have had chance to = > communicate perhaps you can come back to this forum and really get this = > ball rolling... =20 > > Nicholas Borho > Ascension Health > NBorho@AscensionHealth.Org=20 > =20 > >>> 03/29/00 08:15AM >>> > > Anybody out there have a home care program that's up to speed on HIPAA? = > I'm > doing some research on the effect that HIPAA will have on home care > programs, agencies, etc. > > Sara Jackson > > -----Original Message----- > From: Rx2000HIPAA@rx2000.org [mailto:Rx2000HIPAA@rx2000.org]=20 > Sent: Tuesday, March 28, 2000 9:41 AM > To: Rx2000HIPAA@rx2000.org=20 > Subject: MSO/IPA a health plan > > > > Does anyone have the answer to the following? > > Is a mso/ipa that has a full risk contract considered a "health plan" or > provider under hipaa and therefore subject to the rules? > > Stewart M. Presser > Vice President > Greater NY Hospital Association > (212) 506-5444 > > > > > > > > ********** Message #2 ********** > From: mw.davis@baylordallas.edu > To: Rx2000HIPAA@rx2000.org > Subject: RE: medicare fraud > Date: Fri, 31 Mar 2000 15:13:48 -0600 > > Is this a typo - "increase from approximately $455 million in 1997 to $120 > million in 2003". Should it be decrease? > > Michael W. Davis > Baylor Health Care System - Information Services ~ 3801 Main Street - > Dallas, TX 75226 > 214.820.4647 voice ~ 214.820.4241 fax ~ 972.601.0933 pager > 9726010933@page.metrocall.com alpha page > mw.davis@baylordallas.edu > > > > > -----Original Message----- > > From: Rx2000HIPAA@rx2000.org [SMTP:Rx2000HIPAA@rx2000.org] > > Sent: Thursday, March 30, 2000 7:10 PM > > To: Rx2000HIPAA@rx2000.org > > Subject: Re: medicare fraud > > > > In 1992, the U.S. General Accounting Office estimated that healthcare > > fraud amounted to approximately 10 percent of total national health > > expenditures. In 1997, the Department of Health and Human Services (DHHS) > > Office of Inspector General (OIG) reported to Congress that approximately > > 14 percent of Medicare claims were paid inappropriately, due to fraud or > > abuse. Although these stattistics are subject to debate, they fueled the > > enforcement fires. Overpayments of even to or three percent sould still > > add up to millionsand millions of dollars. > > > > In order to deal with these millions of dollars in overpayments, the > > United States Government declared the investigation and procescution of > > healthcard fraud as its #2 priority, second only to investigation and > > prosecution of violent crime. The Health Insurance Portability and > > Accountability Act of 1996 (HIPAA) and the Balanced Budget Act of 1997 > > broadly expanded the enforcement jurisdiction and funding. > > > > FBI healthcare fraud investigations increased from approximately 650 in > > 1992 to over 2,200 in 1996. The FIB's funding for healthcare > > investigations is projected to increase from approximately $455 million in > > 1997 to $120 million in 2003. The OIG received substantial new funding > > for enforcement through HIPAA. The $100 million authorized under HIPAA in > > FY 1997 will grow to $240 million in FY 2003. In FY 97, OIG grew from 900 > > to 1200 employees and opened six new investigative offices. By the end of > > 1999 the OIG is expected to have offices in all 50 states. > > > > Billers and Coders should have nothing substantial to fear as long as > > they are > > doing what is right and reporting questionable practices to their > > supevisiors. Just follow established procedures. Directors, Executives, > > and the Institution itself are going to be the one to take the financial > > hit if billing practices are not compliant. The penalties can be > > significant. Fines of up to $10,000 per claim, mprisonment, exclusion > > from Medicare, Medicaid and other government programs for up to 5 years. > > > > I am only personally aware of one large multi-hospital organization that > > was investigated and found guilty. It made all the news a few years ago. > > They had to pay millions and ended up selling a couple of hundred > > hospitals. > > > > Our Hospital addressed the new laws with a Corporate Compliance policy and > > handbook for all employees and encorporated the program in orientation. > > > > > > > > > > ----- Original Message ----- > > From: Rx2000HIPAA@rx2000.org > > To: Rx2000HIPAA@rx2000.org > > Sent: Saturday, March 25, 2000 6:01 PM > > Subject: medicare fraud > > > > could you please give me you input on the law that is now holding > > coders and billers l responsible is Medicare find fraud in the billing > > even if the coders and billers or not a party to any fraud just poor > > billing practices, also could you give me the name of the law and were it > > can be found my administer thinks I'm making this up about who is liable > > > > Mary M mmbm@thegrid.net > > > > ********** Message #3 ********** > From: Albert-Oriol@smh.com > To: "'Rx2000HIPAA@rx2000.org'" > Subject: RE: Job Descriptions, Other Requests > Date: Tue, 4 Apr 2000 09:28:49 -0400 > > Has anyone created a job description for a HIPAA project manager / > information security officer position and would be willing to share with the > group? Information on $ for this position would also be helpful --we're > struggling with some of the proposals the consulting firms out there are > trhowing at us for the project mgt part alone ... > > thanks > > a. > Albert Oriol > albert-oriol@smh.com > (941) 917 2383 > > "Human beings, who are almost unique in having the ability to learn from the > experience of others, are also remarkable for their apparent disinclination > to do so" -- Douglas Adams > > > -----Original Message----- > From: Rx2000HIPAA@rx2000.org [mailto:Rx2000HIPAA@rx2000.org] > Sent: Monday, March 20, 2000 12:36 AM > To: Rx2000HIPAA@rx2000.org > Subject: Fwd: Job Descriptions, Other Requests > > > > > >(We've been asked to forward to the listserv the following message without > >attribution. Rx2000 requests that you sign your postings, but if you have > >a reason for wishing to remain anonymous we are happy to forward your > >postings anonymously. Please note the suggestion by the author of the > >posting that a subpage be created for "Best Practices" material. The > >Rx2000 website has a "Self-Help Materials" page where we would be happy to > >make this material available. -- Rx2000 Listserv Moderator) > > > > > > A request has been submitted for information regarding the development > > > and/or samples of job descriptions for HIPAA Project Directors or > Project > > > Managers that members are willing to share with the group. > > > > > > Two other topics of interest: > > > Will group members be incorporating HIPAA plans into their Compliance > > > Programs or addressing this issue as part of their IT Strategic Plan? > > > Would members be willing to share the development of their Project > Plans, > > > Policies and technical enhancements that address the HIPAA requirements? > > > This is actually a suggestion for a "Best Practices" subpage where > members > > > could share examples of their work. > > > > > > > ********** Message #4 ********** > From: renae.heisler@hhss.state.ne.us > To: rx2000HIPAA@rx2000.org > Subject: CLIA - HIPAA > Date: Tue, 4 Apr 2000 10:49:20 -0500 > > Does anyone know how CLIA will be handled for HIPAA, specifically on the > UB-92 Forms? CLIA is covered in the (837) Professional Implementation > Guide but it does not look like it is covered under the 837 Institutional > I.G. > > Today, hospital's report lab work on their UB-92's, it does not look like > HIPAA is supporting this procedure. > > Will there be a change in the way lab work is reported in the future? > > Any information to support this question would be greatly appreciated! > > Thank you, > > > > Renae Heisler > State of Nebraska, Medicaid > rheisler@notes.state.ne.us > > > > > > > ********** Message #5 ********** > From: henrybasset@chesapeake.net > To: , > Subject: Re: Job Descriptions, Other Requests > Date: Tue, 4 Apr 2000 20:59:50 -0400 > > Albert, > > SANS has created both project manager and security analyst job > descriptions. One of the good things about the way they do business is that > it is by concensus.. Including the healthcare industry. > > Here's the link: http://www.sans.org/newlook/resources/sjd.htm > > Take care, > Jeff Stutzman > Healthcare ISAC > www.info-security.net > > ----- Original Message ----- > From: > To: > Sent: Tuesday, April 04, 2000 9:28 AM > Subject: RE: Job Descriptions, Other Requests > > > > > > Has anyone created a job description for a HIPAA project manager / > > information security officer position and would be willing to share with > the > > group? Information on $ for this position would also be helpful --we're > > struggling with some of the proposals the consulting firms out there are > > trhowing at us for the project mgt part alone ... > > > > thanks > > > > a. > > Albert Oriol > > albert-oriol@smh.com > > (941) 917 2383 > > > > "Human beings, who are almost unique in having the ability to learn from > the > > experience of others, are also remarkable for their apparent > disinclination > > to do so" -- Douglas Adams > > > > > > -----Original Message----- > > From: Rx2000HIPAA@rx2000.org [mailto:Rx2000HIPAA@rx2000.org] > > Sent: Monday, March 20, 2000 12:36 AM > > To: Rx2000HIPAA@rx2000.org > > Subject: Fwd: Job Descriptions, Other Requests > > > > > > > > > > >(We've been asked to forward to the listserv the following message > without > > >attribution. Rx2000 requests that you sign your postings, but if you > have > > >a reason for wishing to remain anonymous we are happy to forward your > > >postings anonymously. Please note the suggestion by the author of the > > >posting that a subpage be created for "Best Practices" material. The > > >Rx2000 website has a "Self-Help Materials" page where we would be happy > to > > >make this material available. -- Rx2000 Listserv Moderator) > > > > > > > > > > A request has been submitted for information regarding the development > > > > and/or samples of job descriptions for HIPAA Project Directors or > > Project > > > > Managers that members are willing to share with the group. > > > > > > > > Two other topics of interest: > > > > Will group members be incorporating HIPAA plans into their Compliance > > > > Programs or addressing this issue as part of their IT Strategic Plan? > > > > Would members be willing to share the development of their Project > > Plans, > > > > Policies and technical enhancements that address the HIPAA > requirements? > > > > This is actually a suggestion for a "Best Practices" subpage where > > members > > > > could share examples of their work. > > > > > > > > > ********** Message #6 ********** > From: Albert-Oriol@smh.com > To: 'Healthcare ISAC ' , "'Rx2000HIPAA@rx2000.org'" > Subject: RE: Job Descriptions, Other Requests > Date: Tue, 4 Apr 2000 23:00:46 -0400 > > Jeff, > > Thanks for the pointer. Your email actually provides very much appreciated > validation of my "flight-by-night" research. I had just downloaded the SANS > info following a link on a pretty good article in Computerworld (it was > titled something like "Security Manager's Journal"). I can't believe I'd be > targeting the right sites on my own, but it seems that subscribing to all > these web resources does pay off ... small world... > > Anyway, I had saved the files you mention and although I think the project > manager one in particular is broad enough to get me started I was still > hoping to get more info pertinent to HIPAA-related skills (not just the > security aspects of HIPAA, but also the EDI/e-commerce facet as well), and > as important, I was hoping to elicit feedback about realistic $-ranges that > would be appropriate for such position. So any other pointers will be > appreciated. > > Thanks again and keep the feedback flowing > > a. > > Albert Oriol > albert-oriol@smh.com > (941) 917 2383 > > "Human beings, who are almost unique in having the ability to learn > from the experience of others, are also remarkable for their apparent > disinclination to do so" -- Douglas Adams > > -----Original Message----- > From: Healthcare ISAC > To: Rx2000HIPAA@rx2000.org; albert-oriol@smh.com > Sent: 4/4/00 8:59 PM > Subject: Re: Job Descriptions, Other Requests > > Albert, > > SANS has created both project manager and security analyst job > descriptions. One of the good things about the way they do business is > that > it is by concensus.. Including the healthcare industry. > > Here's the link: http://www.sans.org/newlook/resources/sjd.htm > > Take care, > Jeff Stutzman > Healthcare ISAC > www.info-security.net > > ----- Original Message ----- > From: > To: > Sent: Tuesday, April 04, 2000 9:28 AM > Subject: RE: Job Descriptions, Other Requests > > > > > > Has anyone created a job description for a HIPAA project manager / > > information security officer position and would be willing to share > with > the > > group? Information on $ for this position would also be helpful > --we're > > struggling with some of the proposals the consulting firms out there > are > > trhowing at us for the project mgt part alone ... > > > > thanks > > > > a. > > Albert Oriol > > albert-oriol@smh.com > > (941) 917 2383 > > > > "Human beings, who are almost unique in having the ability to learn > from > the > > experience of others, are also remarkable for their apparent > disinclination > > to do so" -- Douglas Adams > > > > > > -----Original Message----- > > From: Rx2000HIPAA@rx2000.org [mailto:Rx2000HIPAA@rx2000.org] > > Sent: Monday, March 20, 2000 12:36 AM > > To: Rx2000HIPAA@rx2000.org > > Subject: Fwd: Job Descriptions, Other Requests > > > > > > > > > > >(We've been asked to forward to the listserv the following message > without > > >attribution. Rx2000 requests that you sign your postings, but if you > have > > >a reason for wishing to remain anonymous we are happy to forward your > > >postings anonymously. Please note the suggestion by the author of > the > > >posting that a subpage be created for "Best Practices" material. The > > >Rx2000 website has a "Self-Help Materials" page where we would be > happy > to > > >make this material available. -- Rx2000 Listserv Moderator) > > > > > > > > > > A request has been submitted for information regarding the > development > > > > and/or samples of job descriptions for HIPAA Project Directors or > > Project > > > > Managers that members are willing to share with the group. > > > > > > > > Two other topics of interest: > > > > Will group members be incorporating HIPAA plans into their > Compliance > > > > Programs or addressing this issue as part of their IT Strategic > Plan? > > > > Would members be willing to share the development of their Project > > Plans, > > > > Policies and technical enhancements that address the HIPAA > requirements? > > > > This is actually a suggestion for a "Best Practices" subpage where > > members > > > > could share examples of their work. > > > > > > > > > > > > > ********** Message #7 ********** > From: hipadmin@rx2000.org > To: > Subject: Rx2000 SIG > Date: Wed, 5 Apr 2000 00:05:36 -0500 > > > Dear Rx2000 Listserv Readers, > > We are very excited about the great lineup of speakers and presentations we > have for the April 25-26 Special Interest Group (SIG) meeting in > Minneapolis! They include: > > - Kevin Thurm, Deputy Secretary, Department of Health and Human Services > > - Joseph Broseker, Deputy Director of Provider Billing and Education, > Health Care Financing Administration > > - Rick Telesca, Senior Research Advisor, GIGA ePractice Research Group > > - Richard Fischer, Partner, Foley & Lardner > > - Allan Abramson, VP of Information Integration, Allina Health System. > > - James Bradley, CEO, Abaton.com, a division McKesson/HBOC > > - Steve Curd, CIO, Healtheon/WebMD > > - Dave Moertel, Electronic Commerce Unit Manager, Mayo Foundation > > The evening reception on the 25th and the concluding afternoon roundtable > discussions on the 26th, > are always extremely popular at Rx2000 SIG meetings and will provide you > unique > opportunities to have a dialogue with these presenters and with your peers > from the healthcare community. > > Full details about the meeting and registration information is on the > Rx2000 website at http://www.rx2000.org . As always, this SIG meeting is > open to members of the Institute as well as non-members. I look forward to > another great SIG meeting and to seeing you there! > > Joel Ackerman, Executive Director > Rx2000 Institute > ackerman@rx2000.org > > > > > > ********** Message #8 ********** > From: hipadmin@rx2000.org > To: > Subject: SIG Meeting Confimations > Date: Thu, 6 Apr 2000 16:30:06 -0500 > > Just a reminder for those of you planning on attending the Rx2000 SIG > meeting in Minneapolis. If you have not received an email confirmation from > Rena at Rx2000 please contact her at 888-835-4478 to confirm your > attendance. > > Thank You! > Rx2000 Communications >