AMCNO/AMEF Sponsored Legal Issues Seminars a Huge Success

The Academy of Medicine of Cleveland & Northern Ohio (AMCNO) and the Academy of Medicine Education Foundation (AMEF) co-sponsored their annual legal issues seminars in April that were well-attended by both physicians and physician office staff. Presenters included John Mulligan, Esq., from McDonald Hopkins, LLC, David Valent, Esq., from Reminger Co., L.P.A., and Amy Leopard, Esq., from Walter and Haverfield LLP with President-Elect Dr. Laura David facilitating both sessions. The presenters informed the audience of the legal issues currently impacting physicians in their practices.

During the first session, Mr. Mulligan talked about the evolution and change involving the privacy and security of patient information. Audience members were cautioned that while they may receive requests for the release of medical records that are deemed to be HIPAA compliant disclosures, in fact they may not be authorized.

In the event you are made aware of a breach, notice must be given to the patient and also the Department of Health and Human Services without unreasonable delay but not more than 60 days after the discovery. Where more than 500 individuals are involved, media notice is also required. Depending on the nature of the breach, HITECH Act monetary penalties can range from $100 to $50,000 per violation.

In addition, the HITECH Act expanded HIPAA standards to institute liability for business associates with breaches of privacy of health information. There now are civil and monetary penalties associated with these. Too, it is significant that if either the business associate or covered entity becomes aware of a breach by the other, they must provide the other with notice and ensure that the other takes reasonable steps to clear the breach. If this does not happen, the contract must be terminated.

The next topic, “Are you RAC Ready?”, was presented by Mr. David Valent and included an overview of the recovery audit contractor (RAC) process for Medicare reimbursements in order to assist audience members with becoming RAC ready. In 2007 with Medicare errors representing $10 billion in lost monies, the government and congress enacted legislation that led to establishing the new RAC process to facilitate the recovery of payment for the most common billing errors, including incorrect payment amounts, duplicate claims/services, claims for non-covered services and incorrect coding.

The final presentation by Ms. Amy Leopard reviewed the framework for the new Medicare and Medicaid electronic health records (EHR) incentive programs and the new Centers for Medicare and Medicaid Services (CMS) proposal on Meaningful Use (MU) eligibility. Since CMS published the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs Notice of Proposed Rule Making (NPRM), the AMCNO physician and staff leadership have examined the ruling for problem areas and have prepared and submitted a letter to CMS identifying such. A complete copy of the presentations will be available in the May/June issue of the Northern Ohio Physician magazine.