1 / 10

Donald Sinko, CPA Cleveland Clinic Chief Integrity Officer

HIPAA, Documentation, and Billing Compliance, Oh My!. Donald Sinko, CPA Cleveland Clinic Chief Integrity Officer. Promoting a Culture of Integrity and Ethical Behavior. Commitment to a Strong Corporate Compliance Program Strong senior management support

willow-mullins
Download Presentation

Donald Sinko, CPA Cleveland Clinic Chief Integrity Officer

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. HIPAA, Documentation, and Billing Compliance, Oh My! Donald Sinko, CPA Cleveland Clinic Chief Integrity Officer

  2. Promoting a Culture of Integrityand Ethical Behavior Commitment to a Strong Corporate Compliance Program • Strong senior management support • Awarded 2009/2010 World’s 100 Most Ethical Companies • Comply with federal, state and local laws and regulations • Policies and standards of conduct

  3. Chief Integrity Officer: Reporting Lines Audit Committee of the Board of Directors Chief of Staff Corporate Compliance Committee Chief Integrity Officer CEO Office of Internal Audit Office of Corporate Compliance

  4. Promoting a Culture of Integrityand Ethical Behavior Integrity of Our Process • Compliance program procedures to prevent, detect and correct non-compliance • Compliance with contracts is audited • Cleveland Clinic has adopted the PhRMA Code and the AdvaMed Code of Ethics • Nationally recognized conflicts of interest policy

  5. Increased Scrutiny and Regulations • Mandating compliance (CMS, OIG Congress) • HIPAA privacy and security • Electronic medical record documentation • RAC and insurance company billing audits • FDA research audits • Physician contracts • Quality and safety • Form 990 tax compliance • Conflicts of interest

  6. Patient Data Privacy and Security • American Recovery and Reinvestment Act • Establishing standards • Importance of encrypting data • Laptops, thumb drives, Blackberry’s • Increased penalties • Properly dispose of PHI • De-Identify patient information • Breach reporting standards • HIPAA security risk analysis

  7. Other Compliance Issues • HIPAA • Unauthorized access • Unauthorized disclosures • Patient access to mental health records • Protecting drug and alcohol treatment records • HIPAA 5010 • Documentation shortcuts (e.g., copy & paste) • Coding/billing practices • Governmental improper payment initiatives • RAC, MIC, MAC, ZPIC

  8. Research Compliance Issues • Billing research charges vs. std. of care • Compliance with IRB approved protocols • HIPAA related to outside researchers • Ownership of research data • Consenting process • Conflicts of interest

More Related