Medicare Compliance & Reimbursement

The tell-tale signs of compliance cons - and how to avoid them.  From companies offering "certified" HIPAA training to those masquerading as state-contracted HIPAA service providers, scammers are preying on the innocent in order to stuff their wallets full of your cash. Knowing how to respond to these solicitations will save you big. Here's a potentially thorny situation: A medical office receives a call from an organization claiming to be under contract to a state agency to provide HIPAA training. The caller says that the medical practice is required to attend a HIPAA training seminar next month, but the practice isn't familiar either with the solicitor or the state agency the caller claims to represent. No, it's not a hypothetical situation - this did occur. Fortunately this health care provider had the sense to contact its outside counsel to make sure it wasn't being hoodwinked, but this sort of solicitation is happening all the time. "There are a lot of companies out there offering 'HIPAA-certified' training programs or claiming that they'll certify you as HIPAA-compliant, while some will offer to 'certify' trainers to teach HIPAA," says Gretchen McBeath, an attorney in the Columbus, OH office of Bricker & Eckler. She warns entities that any of these solicitations could easily be bogus. McBeath says one Web site she found holds its HIPAA training programs out as "legally certified," and others have trainers that are "fully certified." Still other programs say, "BE A CERTIFIED HIPAA PROFESSIONAL!" The problem is, "we never know by whom they are certified or what the standards are for this certification." And the Centers for Medicare & Medicaid Services recently caught wind of another type of scam involving HIPAA and Medicaid. CMS warned some medical associations to be on the lookout for companies that are attempting to perform HIPAA-Medicaid cons. CMS said the company would ask for a person by name, advise that person that a HIPAA seminar was taking place at a certain hotel in or near their area, and would aggressively assert that the physician must attend the seminar and that attendance was mandatory. The fee was $200 if a credit card number was provided immediately, but increased to $400 if they wished to pay at the door. While the seminar may or may not have been legitimate, don't be fooled if this happens to you and be sure to report this information to your CMS regional office. In addition to CMS' awareness of such schemes, the HHS Office of Inspector General says there have been scores of reported HIPAA and Medicaid scams perpetrated on CEs this year. Judy Holtz, a spokesperson for the OIG, says a group called Doctor's Assistance Corp. "uses strong sales tactics" [...]