HIPAA
What Date did HIPAA become effective?
August 21,1996
How often should you change your password?
Every 60-90 Days
What is the number to our Non-Retaliation Policy?
COMP-23
True or False: The Stark Law only applies to Medicare and Medicaid Patients.
True
True or False: Was the FCA referred to as the Lincoln Law?
True: The False Claims Act was often called the "Lincoln Law" because it was originally enacted during President Abraham Lincoln's administration in 1863. At that time The US was facing rampant fraud by contractors supplying the Union Army during the Civil War.
What does HIPAA stand for?
Healthcare Insurance Portability and Accountability Act
How many calendar days from discovery do you have to report a breach?
60 Days
True or False: Does CMS require a Medicare Advantage Organization to have a reporting hotline?
True
What type of penalties could you incur if you violate the Anti-Kickback Statue?
Criminal and Civil
What is Upcoding?
Misrepresenting the type or complexity of services provided to receive a higher reimbursement than is appropriate.
What is the primary purpose of HIPAA?
To protect the privacy and security of patients' health information.
What should you do if you receive a suspicious email asking for sensitive information?
Do not click on any links or attachments and report to the IT Department..AKA CAM
What is the Mass Advantage Hotline number?
833-215-7231
What is the main purpose of the Stark Law?
To limit physician self-referrals where there is a financial relationship.
Who can be held liable under FCA?
Liability under the FCA can extend to individuals, corporations, contractors, or any entity that knowingly submits, or caused to be submitted, false claims to the government.
What other three areas did HIPAA expand into?
Privacy Rule, Security Rule, and HITECH Act
True or False: Only employees in IT are responsible for data security within the organization.
False - Data security is EVERYONE's responsibility.
What should an employee do if they feel they are being retaliated against?
They should report the suspected retaliation to their compliance officer, HR department, or through the anonymous reporting hotline.
True or False: Under the Anti-Kickback Statute, it is acceptable for a healthcare provider to receive payment from a pharmaceutical company as long as it's for recommending their products to patients.
False - The Anti-Kickback Statute prohibits accepting payments or incentives in exchange for referrals or product recommendations, as this could lead to biased patient care.
What does "knowingly" mean under FCA?
It means actual knowledge, deliberate ignorance, or reckless disregard of the truth.
Name three examples of identifiers that, when combined with health information, make data protected under HIPAA.
Name, SSN, Address, DOB, Telephone numbers, Medical Records, Email
Who must be notified when a data breach involves PHI?
HHS, the affected individuals, and sometimes the media must be notified, depending on the breach size.
Why is anonymous reporting important for a compliance program?
It allows employees to report concerns without fear of retaliation, which can increase reporting of issues that might otherwise go unreported.
What is one of the primary goals of both the Stark Law and Anti-Kickback Statute?
to ensure we’re always making decisions in the best interest of our patients.
What is the reward for a whistleblower?
Whistleblowers may receive 10-30% of the monetary sanctions collected