Straying Outside of HIPAA Compliance May Be Dangerously Simple

Straying Outside of HIPAA Compliance May Be Dangerously Simple

By and large, urgent care operators are very diligent when it comes to following the guidelines laid down in the Health Insurance Portability and Accountability Act of 1996—much better knowns as HIPAA. However, even without malice aforethought, you may inadvertently stray into noncompliance, leaving your business open to serious penalties. Such was pointed out in a FierceHealth article that discussed ways it’s easy for medical providers in general to slip out of compliance; in fact, …

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‘Upcoding’ Allegations Cost One Urgent Care Company $2 Million—Don’t Let It Happen to You

‘Upcoding’ Allegations Cost One Urgent Care Company $2 Million—Don’t Let It Happen to You

An urgent care company has agreed to pay $2 million to settle whistleblower allegations that it submitted inflated claims to Medicare and Medicaid programs—known as “upcoding”—over a 5-year period in two New England states. Specifically, the Department of Justice charged that the company ordered its clinicians to examine and document multiple, specific body systems while taking the medical histories and performing physical exams, whether that level of attention was warranted by the patients’ complaints or …

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Remember: ADA Rules Apply to Employees, Not Just Patient Accessibility

Remember: ADA Rules Apply to Employees, Not Just Patient Accessibility

Urgent care centers as a whole go to great lengths to ensure their locations and facilities are accessible to all patients, regardless of any special needs they may have. It can be easy to overlook the employers’ responsibility under the Americans with Disabilities Act (ADA) to also provide accommodations that allow employees to do their jobs. One need look no further than a lawsuit in Virginia to be reminded, however. The case of a healthcare …

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Even with the Best Intentions, Whistleblowing is Grueling for All Concerned

Even with the Best Intentions, Whistleblowing is Grueling for All Concerned

Are whistleblowers bottom feeders who betray their employers to make a buck, or crusaders for the public good, responsible for bringing to light corporate or government malfeasance? Whichever your answer, the fact is that whistleblower lawsuits, to which urgent care operations are clearly not immune, take a massive toll on both the whistleblower/complainant and the defendant in the suit. The majority of cases involve healthcare, with Medicare fraud being an especially rich field (probably not …

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Beware the Bad Apples When Hiring New Clinical Staff—if You Can Identify Them

Beware the Bad Apples When Hiring New Clinical Staff—if You Can Identify Them

The National Practitioner Data Bank (NPDB) was created to record malpractice payments, disciplinary action, restrictions of privileges, and other red flags for physicians who may be less likely to provide excellent care for others. Unfortunately, as with any solution to a real problem, it’s not perfect. Providers with poor records may not get flagged in spite of past transgressions. That can present a real problem when you’re trying to hire clinical staff in a hurry. …

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Check a Clinical Candidate’s Background—for the Safety of Your Patients and the Practice

Check a Clinical Candidate’s Background—for the Safety of Your Patients and the Practice

No responsible urgent care operator would knowingly employ a clinician whose history included behavior that put patients at risk, whether that meant irresponsible prescribing, claims of inappropriate behavior, or just plain incompetence. Unfortunately, just checking that a job candidate’s CV is on point and verifying references isn’t sufficient if someone has something to hide. A new report produced by the Milwaukee Journal Sentinel, USA Today, and MedPage Today tells the tale of a surgeon who …

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Think You’re Immune to the Threat of Embezzlement? So Did This Urgent Care Giant

Think You’re Immune to the Threat of Embezzlement? So Did This Urgent Care Giant

Medical practices—including urgent care centers—are the sites of financial crimes far more often than they should be. From sloppy bookkeeping to outright embezzlement, the consequences of not minding the books closely could be catastrophic for your business and your reputation. Let us interrupt you from thinking It couldn’t happen to me by suggesting that you read on. One of the largest urgent care operators in the country just saw a former manager get sentenced to …

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Focus on Preventing Sexual Harassment Across Urgent Care, Not Investigating Case-by-Case

Focus on Preventing Sexual Harassment Across Urgent Care, Not Investigating Case-by-Case

Sexual harassment is a “chronic debilitating disease” in healthcare settings—and it needs to be treated as such, according to a pair of Perspective articles in the New England Journal of Medicine. As one of them points out, the National Academies of Science, Engineering and Medicine issued a report stating that up to 50% of female medical students will experience some form of sexual harassment before they even get out of med school. The morality (or …

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Nobody Wins When Social Media Battles Get Out of Hand

Nobody Wins When Social Media Battles Get Out of Hand

There’s no question that positive reviews on social media can help drive new patients to your urgent care center. The counterpoint to that is that negative reviews have the potential to keep even formerly satisfied customers from returning. Things have escalated beyond simple comments online in the case of a Michigan healthcare facility and a family that was unhappy with the care they received. That family first aired its grievances over the care one family …

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Guard Patient Privacy Like You Would Your Own—or Face the Consequences

Guard Patient Privacy Like You Would Your Own—or Face the Consequences

Prosecutions for relatively small-time violations of patient privacy under the Health Insurance Portability and Accountability Act (HIPAA) are becoming more common, in spite of the fact that larger-scale data breaches and fraud investigations grab all the headlines.  One reason: Such violations may be low-hanging fruit that helps federal prosecutors win convictions more easily than more sweeping investigations. The HIPAA “privacy rule” sets standards to protect individuals’ medical records and other personal health information, requiring that …

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