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Written by Jeffrey Herschler   
Wednesday, 15 December 2010 20:02

It's tempting to delay any big decisions at the Group Practice level since (According to in an article entitled Health Care on Voters' Minds) Rep. John Boehner, R-Ohio, in line to be House speaker..., has vowed to "do everything" he can "to stop Obamacare." He included cutting off the appropriations necessary to implement the law.  It's better to sit tight until everything shakes out, right? 

"No" says Alexandra Johnson, a practice management consultant for Coleman Consulting Group.  "The challenge to HC reform is being mounted by Republicans and many Democrats as well.  Regardless of whether the law is repealed, in whole or in part, the changes needed are significant and not the type of issues providers will be able to research, resolve, change and implement on a dime" she stated.  Furthermore, according to Board Certified Health Lawyer William Spratt (in the November 8th issue of the Daily Business Review), "If Congress revisits the overhaul law, it will not likely reverse the provisions that address efficiency, quality of care and cost-containment."

Meanwhile the HiTech Act and its carrot and stick incentives promoting EHR adoption is not part of Healthcare Reform. The HiTech Act is part of the Stimulus Package passed early in 2009 and is here to stay.  Therefore, it is essential for every practice to adopt EHR or face stiff penalties and competitive disadvantage. Please see EHR Incentive Program to learn more.  Also, an excellent source for information on EHR systems can be accessed by clicking here.

Another potential pitfall associated with the wait and see approach is the potential to run afoul of the Red Flags Rule.  According to the FTC (charged with enforcement of the rule) "The Red Flags Rule...requires certain businesses and organizations - including many doctors' offices, hospitals, and other health care providers - to develop a written program to spot the warning signs - or "red flags" - of identity theft."  The enforcement of the rule is scheduled to commence on Jan 1.  For a quality primer on the Red Flags Rule and how it might affect your practice, please see Todd Demel's article Understanding the Red Flags Rule in the Compliance Update section of this website.  Please note, recent legislation may let providers off the hook. See A Red Flag Reprieve for Health Care Providers? The Door Remains Open Pending Federal Agency Action for details.

With record setting budget deficits and countless instances of improprieties, it's no surprise that a pillar of the government's cost containment strategy is to fight fraud waste and abuse.  According to Mr. Spratt (again quoting from the November 8th DBR article), "...CMS will expand the role of recovery audit contractors and use new technologies to better detect and prevent fraud.  In addition, CMS will tighten its Medicare enrollment and payment policies to keep bad actors out of the program."  Not to be outdone, the OIG has announced a new program to curtail abuse.   If you missed last week's issue of FHIweekly, I encourage you to read Ben Frosch's excellent article entitled Breaking it down: Analysis of 2011 OIG Work Plan (Medicare Part B).  Most experts agree that a review of the practice's Compliance Program is necessary at least every year.   To locate a Board Certified Health Lawyer in your area, click here.

Yes we are in an extraordinary period of economic and regulatory uncertainty.  That said this is no time for inaction.  Let's hope Mr. Spratt is correct in his upbeat closing comments of the previously mentioned article: "Change in the healthcare system brings opportunity."

Last Updated on Thursday, 23 December 2010 06:53

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