Author: Doupnik, Anita; Lusk, Katherine

Source: Journal of AHIMA

Publication Date: September 2017

Editor’s Note: This is the eighth installment in an ongoing series highlighting information governance case studies.


Auditing in healthcare is an internal and/or external process intended to assess, evaluate, and improve quality of care and services while also ensuring....

Author: Meehan, Ann M.

Source: External - used with permission

Publication Date: August 2017

Article from the Health Care Compliance Association's Compliance Today.

Author: Carey, Susan

Source: Journal of AHIMA

Publication Date: May 2017

So far 2017 is shaping up to be the year of fear in the realm of healthcare cybersecurity. There was a 61 percent increase in healthcare cyberattacks in 2016. This followed two years of steadily increasing cyberthreats in healthcare, including 93 major cyberattacks in 2016 resulting in com....

Author: Wiedemann, Lou Ann

Source: Journal of AHIMA

Publication Date: April 2017

Editor’s Note: The following is an excerpt from the new “External HIPAA Audit Readiness Toolkit” developed by AHIMA. The full toolkit is free for AHIMA members.


THE HITECH OMNIBUS Rule mandated that the US Department of Health and Human Services (HHS) condu....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: April 2017

A Beverly Hills plastic surgeon, let’s call him Dr. Hollywood, has a thriving business—an impeccable office, gracious and welcoming staff, and top of the line equipment and devices. His clientele is primarily celebrities and other wealthy socialites who can afford to pay out of....

Author: Primeau, Debra

Source: Journal of AHIMA

Publication Date: April 2017

Smaller healthcare facilities typically lack the resources and expertise to address the constant flow of competing priorities, forcing leadership to wear many hats in a fragmented environment. Few have a designated privacy, security, or compliance officer, let alone the corporate support s....

Author: Eramo, Lisa A

Source: Journal of AHIMA

Publication Date: February 2017

Anxiety—it’s the emotion that looms over most patient financial services (PFS) directors and those working in health information management (HIM) when they discover that their organization’s claims are subject to a Centers for Medicare and Medicaid Services (CMS) Recovery....

Author: Downing, Katherine

Source: Journal of AHIMA

Publication Date: February 2017

Healthcare organizations are under constant attack from cybercriminals due to the richness of information they collect, store, and disseminate that can also be used for multiple types of fraud and identity theft. Stolen credit card information only lasts until the victim cancels the card,....

Author: Beckett, Barb; Beidler, Aurae; Halpert, Aviva M.; Davis, Nancy; Gorton, Elisa R.; McLendon, Kelly; Rose, Angela Dinh; Shindell, Roger; Tucker, DeAnn

Source: AHIMA toolkit

Publication Date: January 2017

The toolkit you are trying to access is available to non-members for $99.95.
Click here to purchase.

Author: McLendon, Kelly

Source: AHIMA toolkit

Publication Date: January 2017

overview of the Office of Civil Right’s HIPAA Audit Protocol, including summaries

Author: DeVault, Kathryn; Easterling, Sharon; Huey, Kim

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: January 2017

In the current era of healthcare transformation, the continuing importance of documentation and coding cannot be overstated. With the multitude of acronyms being added to the healthcare vocabulary, one may wonder where documentation and coding fits in. It’s important to remember that....

Author: Marting, Richelle; DeMasters, Dana

Source: Journal of AHIMA

Publication Date: January 2017

Despite its codification under the administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA), those responsible for compliance often agree HIPAA is anything but administratively simple. Even the plethora of resources offering HIPAA guidance....

Author: Clack, Crystal; Freeman, Rae; Lewis, Laquette

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2017

A cyclone of regulatory requirements for providers has officially touched down in the United States. The Affordable Care Act (ACA), Medicare Access and CHIP Reauthorization Act (MACRA), patient-centered medical home (PCMH), and value-based purchasing (VBP) initiatives are contributing to dramat....

Author: Denton, Debra Beisel; Endicott, Melanie; Ericson, Cheryl E; Love, Tammy R.; McDonald, Lori; Willis, Daphne

Source: AHIMA practice brief

Publication Date: December 2016

One of the more challenging tasks for both coding and clinical documentation improvement (CDI) professionals is clinical validation. This is a relatively new responsibility that has evolved as CDI programs mature and CDI and coding professionals advance their knowledge and collaboration on clin....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: November 16, 2016

As a presenter at this year’s AHIMA Annual Convention and Exhibit, I covered many topics. While I plan to post about others in subsequent posts, this month I want to discuss a subject that many healthcare providers and their staff members might find unfamiliar: the National Labor Rela....

Author: AHIMA Work Group

Source: AHIMA practice brief

Publication Date: October 2016

This update supersedes the November 2013 practice brief, Guidelines for a Compliant Business Associate Agreement.



The Privacy Rule portion of the Health Insurance Portability and Accountability Act (HIPAA) defines a "business associate (BA) as a person or entity that performs....

Author: Land, Daniel

Source: Journal of AHIMA | Journal of AHIMA - Coding Notes

Publication Date: October 2016

The complex and sophisticated nature of ICD-10-CM/PCS has increased both the intellectual demands on coding professionals and the importance of an educational approach to the audit process. On October 1, 2016 regular updates to ICD-10 will begin, marked by the introduction of over 5,500 n....

Author: Zastoupil, Shawna

Source: AHIMA newsletter article | CodeWrite

Publication Date: October 2016

Like many other healthcare settings, hospices are starting their journey into coding compliance. Before the first Federal Regulation (FY 2013), which addressed diagnosis coding clarification, hospices typically reported one code on their claims. Since that time, the Department of Heal....

Author: Twiggs, Mariela; Goldstein, Sara

Source: Journal of AHIMA

Publication Date: October 2016

Healthcare provider organizations rely on a variety of entities to help them carry out healthcare activities and functions. If these entities create, maintain, or transmit protected health information (PHI) on behalf of a provider organization, they are considered a business associate (BA....

Author: Campbell, Angela; D'Amato, Cheryl; Rugg, Donna

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: September 2016

Editor’s Note: This Practice Brief is an update of the March 2010 version, which replaced the November 2007 Practice Brief “Planning for Present on Admission.”


Section 5001(c) of the Deficit Reduction Act of 2005 requires hospitals to report patient primary and....

Author: Denton, Debra Beisel; Endicott, Melanie; Ericson, Cheryl E; Love, Tammy R.; McDonald, Lori; Willis, Daphne

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: July 2016

This practice brief has been updated. See the latest version here. This version is made available for historical purposes only.

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: June 2016

As this blog is about legal consequences, I try to provide current examples of what those consequences might be using a specific set of facts. This month’s example comes from the filming of a documentary television series in New York and Presbyterian Hospital (NYP), one which left me with....

Author: Rose, Angela Dinh

Source: Journal of AHIMA

Publication Date: June 2016

The HITECH Omnibus Rule mandated that the US Department of Health and Human Services (HHS) conduct periodic audits on the privacy and security compliance of covered entities and business associates. It was during the Office for Civil Rights (OCR) update session on March 21, 2016 at the 20....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: June 2016

Teachers know there are two kinds of students. Student A studies and does their assigned reading throughout the whole semester, earning extra credit where they can. When the final exam rolls up, they’re anxious but prepared—they did their homework. Student B, on the other hand, has the sa....

Author: Maimone, Carol

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: June 2016

Physician queries have historically been an effective communication tool used by health information management (HIM) coding professionals to clarify documentation in the health record for accurate code assignment. The goal for any coding professional is to have all final coded diagnoses an....

Author: Boomershine, Julie

Source: Journal of AHIMA

Publication Date: June 2016

From privacy and security risk assessments to perennial health plan record reviews, HIM departments are inundated with audits. The move to ICD-10-CM/PCS adds another layer of audit complexity and requirements as hospital and health systems step up their coding quality review processes, pr....

Author: Lee, Christine

Source: ICD-TEN Top Emerging News | AHIMA newsletter article

Publication Date: May 2016

Just as ocean tides shift with the earth's gravitational pull, physician practice administrators align staff and focus resources to address their organizations' most pressing concerns. This year, the tsunami grabbing administrators' attention is the conclusion of a one-year grace peri....

Author: Lee, Mee Jeong; Kim, Yeaeun; Kim, Ok-nam

Source: Journal of AHIMA

Publication Date: May 2016

Maintaining the privacy of personal health information (PHI) is important whenever information is gathered, be it for the primary purpose of delivering healthcare, or secondary uses such as clinical research and population health. According to the International Organization for Standardiza....

Author: Rose, Angela Dinh

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: April 28, 2016

AHIMA hosted a very engaging Twitter chat on Thursday, April 14, 2016, about the role that privacy and security plays towards launching and implementing successful information governance (IG) programs. To see Tweets from the chat and other information governance (IG) related Tweets, v....

Author: Saharia, Devendra

Source: Journal of AHIMA

Publication Date: April 2016

Disruptive technology can turn any industry on its head—virtually overnight. Just five years ago, summoning a taxi was an inefficient, time-consuming effort that often involved dialing up a dispatcher, who contacted a driver, who would then make their way to your location, perhaps in an h....

Author: Lee, Christine

Source: Journal of AHIMA

Publication Date: April 2016

According to the American Medical Association (AMA), physician practices continued a slow but steady transition toward hospital ownership in 2015. In their July 2015 study, the AMA reported a decrease in physician-owned practices alongside a continual increase in physicians working direct....

Author: Greene, Adam H

Source: Journal of AHIMA

Publication Date: April 2016

In 2009, CONGRESS passed the Health Information Technology for Economic and Clinical Health (HITECH) Act, which granted individuals a right to have a copy of their records sent to a third party, according to 42 U.S.C. § 17935(e) of the regulation.


Unfortunately, many attorn....

Author: Wilson, Donna D

Source: CodeWrite

Publication Date: February 2016

Make a fresh start in the new year by revamping coding compliance plans to include a second level review of all claims that group into MS-DRGs 981-989 (Operating Room Procedure/Unrelated to Principal Diagnosis). Historically, MS-DRGs 981-989 have been "low hanging fruit" for outside audito....

Author: Godbey-Miller, Barbara

Source: Journal of AHIMA - website

Publication Date: January 2016

This article is published in sponsorship with Berkeley Research Group (BRG).


The year preceding the ICD-10 compliance date was filled with a myriad of challenges for health information management professionals, from department heads to coders, regarding ICD-10 implementation.....

Author: Brinda, Danika

Source: Journal of AHIMA

Publication Date: January 2016

Stories about workforce members inappropriately accessing health information continue to plague the Department of Health and Human Services’ Data Breach Portal—which lists US provider data breaches that affect more than 500 individuals. Recently two data breaches reported on th....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: December 18, 2015

This is the last Legal e-Speaking post of 2015. I thought I would use it to predict what 2016 might bring in litigation and beyond. When looking ahead to the next year, there are many possible things that HIM professionals should keep an eye out for, but five stand out to m....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: November 2015

The HIM Problem


Completing regular privacy risk assessments is one of the most proactive ways of preventing healthcare privacy breaches. However, finding helpful tools for these assessments is hard to come by.


The HIM Problem Solver: Sharon Lewis, MBA, RHIA, CHPS, CP....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: November 18, 2015

With new technology comes new opportunities… as well as the potential for litigation. Take 3D implanted devices for example. Implanted devices are commonplace in healthcare. These devices can accomplish a range of tasks, such as deliver timed dosages of drugs, monitor....

Author: Lucci, Susan; Walsh, Tom

Source: Journal of AHIMA

Publication Date: November 2015

One of the most alarming statistics in the news, which is growing with intent and severity, is the prevalence of cyber-attacks, particularly in healthcare. It is an alarming trend that has gained a good deal of attention. For example, in July 2015, UCLA reported that up to 4.5 million pati....

Author: U.S. Centers for Medicare & Medicaid Services

Source: Government (U.S.)

Publication Date: October 06, 2015

State Operations Manual Appendix C

Author: VanderMolen, Julia; Prince, Alesha; Neu, Emily; DeKraker, Rachael

Source: Educational Perspectives in Health Informatics and Information Management

Publication Date: October 2015

Abstract


Introduction: The healthcare industry is an ever-changing field, and in recent years, the introduction of the electronic health record (EHR) has enabled hospitals to store and retrieve detailed patient information for use by healthcare providers, and sometimes patients, d....

Author: Burgess, Sheila

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: October 2015

The dawn of October also welcomes the official go-live date for ICD-10-CM/PCS—meaning there is absolutely no time left to waste in preparing for the additional documentation requirements necessary for successful ICD-10 implementation. Over the past several years, the healthcare industry h....

Author: Crump, Dawn; Tice, Carolyn

Source: Journal of AHIMA

Publication Date: October 2015

The mere mention of the words “payer audits” can send even the most confident and capable health information management (HIM) directors into downward spirals of frustration and overload. These feelings are well known to providers who have found themselves forced to tread the mu....

Author: Lewis, Sharon

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: September 2015

In June I delivered a presentation, “Breach Prevention Part I: Take a PHI Pause—Conduct an Actionable Privacy Risk Assessment,” at a breakout session at the 2015 California Health Information Convention and Exhibit. Finding resources to create a presentation on conducting....

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: September 2015

Editor’s Note: This is the final installment in a series of four articles that discuss the eight Information Governance Principles for Healthcare™.


AHIMA’s Information Governance Principles for Healthcare™ (IGPHC) provide a framework for healthcare organizations to enhance....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: July 2015

The HIM Problem: The US Department of Health and Human Services’ Office of the Inspector General (OIG) is expected to increase enforcement activities surrounding clinical documentation and fraud. Training and awareness are key in preventing penalties.


The HIM Problem Solver:....

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: June 2015

Editor’s Note: This is the third in a series of four articles that discuss the eight Information Governance Principles for Healthcare.


AHIMA’s new Information Governance Principles for Healthcare (IGPHC) provide a framework for healthcare organizations to leverage informati....

Author: DuBravec, Daniel A; Daigle, Matt

Source: Journal of AHIMA

Publication Date: June 2015

With student safety and privacy an increasing parental concern, school administrators nationwide are sitting on a powder keg of potential backlash because of a gray area of student privacy protections that Julia Lear, senior advisor for the Center of Health and Health Care in Schools at G....

Author: Drake, Suzanne P

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: May 2015

The organizations health information management professionals serve are reliant on their understanding of outpatient coding and reporting conventions to ensure that the reimbursement received by facilities is accurate and not subject to improper payment audits.


The National....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: April 2015

In movies and on television lately, Hollywood has made encryption and decryption look exciting, glamorous, and world-saving. The film The Imitation Game and the BBC show The Bletchley Circle chronicle how British code breakers decrypted military strategy codes from the Nazi encryption tool....

Author: Thomas, Jeane

Source: Journal of AHIMA

Publication Date: April 2015

Imagine your organization is involved in a lawsuit or government investigation and needs to access documents or information located outside the United States. If you think you can just demand that they be sent to the US because they are relevant or maybe even necessary for the legal matte....

Author: Dimick, Chris

Source: Journal of AHIMA

Publication Date: April 2015

The spiders of time have been hard at work on the US healthcare privacy and security rules, to the point that their place in health IT interoperability has become fogged and is inhibiting their proper role in the meaningful exchange of health information, according to Lucia Savage, JD, th....

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: April 2015

Editor’s note: This is the second in a series of four articles that discuss the eight Information Governance Principles for Healthcare.


AHIMA’s new Information Governance Principles for Healthcare (IGPHC) provides a framework for healthcare organizations to enhance their ab....

Author: Zeiour, Collette; Twiggs, Mariela

Source: Journal of AHIMA

Publication Date: April 2015

With more than 1,000 large breaches of protected health information (PHI) on record, it’s not surprising that PHI disclosure management is currently top of mind for healthcare leaders.1 Many of these breaches have cost organizations between $1 million and $5 million in penalties, not to m....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: March 12, 2015

Legal consequences flow from the use or abuse of EHR. This monthly column presents examples of what those consequences can be.



Healthcare providers receive and respond to subpoenas on a regular basis. Providers routinely produce personal health information (PHI) when doing so....

Author: DeVault, Kathryn

Source: CodeWrite | AHIMA newsletter article

Publication Date: March 2015

Although they were minimal, the 2015 ICD-10-CM Coding Guidelines contained some updates that should be reviewed, as they provide additional clarification for coding in ICD-10-CM. A complete set of the 2015 guidelines can be found on the CMS website. Several of the guideline changes and upd....

Author: Beckett, Barb; Downing, Kathy; Gillespie, Joe D; Waugh, Traci

Source: Journal of AHIMA

Publication Date: March 2015

Since its initial adoption the HIPAA Privacy Rule has granted individuals the right to request restrictions on the use or disclosure of their protected health information (PHI) for treatment, payment, and healthcare operations (TPO), as well as for disclosures to family members and certai....

Author: Rogers, Anne M

Source: Journal of AHIMA

Publication Date: March 2015

HIPAA-HITECH regulations have imposed many important compliance requirements on US healthcare organizations, large and small. However, the reality is that many small- and medium-sized healthcare organizations, private practitioners, and non-profit clinics often struggle to comply with the....

Author: AHIMA Advocacy and Policy Team

Source: Journal of AHIMA

Publication Date: March 2015

OIG's 90-page work plan for fiscal year 2015 (FY15) offers a high-level view of the office's continued monitoring of various HHS programs and initiatives, particularly those designed to ensure the appropriateness of Medicare and Medicaid payments. The work plan also outlines many of the government's activities in FY15 designed to ensure care quality and safety in hospitals and other healthcare settings.

Author: Crump, Dawn; Hennum, Jeannie

Source: Journal of AHIMA - website

Publication Date: March 2015

The Affordable Care Act (ACA) has a dramatic ripple effect on the healthcare industry—and will continue to create seismic shifts for many years to come. One important change for health information management (HIM) professionals to understand is the impact of ACA on health plan audits. Alre....

Author: Wilson, Donna D

Source: CodeWrite

Publication Date: February 2015

Editor's note: The Centers for Medicare and Medicaid Services (CMS) has delayed the commencement of work under the Recovery Audit contract for durable medical equipment (DME), home health (HH), and hospice reviews. For more information and further updates on this new development, please s....

Author: Don, Hardwick; Twiggs, Mariela; Braden, James H

Source: Journal of AHIMA

Publication Date: February 2015

A mere two decades ago, healthcare providers didn’t face significant penalties for improperly disclosing protected health information (PHI). Since then, regulations surrounding the privacy and security of PHI have evolved to include strict requirements and corresponding steep financial pe....

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia

Source: Journal of AHIMA

Publication Date: February 2015

Editor’s note: This is the first in a series of four articles that will discuss the eight Information Governance Principles for Healthcare.


AHIMA’s newly introduced Information Governance Principles for Healthcare (IGPHC) provides a framework for healthcare organizations to....

Author: Haik, William E

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: February 2015

It is a well known fact that ICD-9-CM diagnosis and procedure codes impact hospital reimbursement and compliance. But there is an additional code that often flies under the radar—the discharge status code. Inaccurate discharge status code assignments for Medicare post-acute care transfers....

Author: Redd, Andrew; Pickard, Steve; Meystre, Stephane; Scehnet, Jeffrey; Bolton, Dan; Heavirland, Julia; Weaver, Allison Lynn ; Hope, Carol; Garvin, Jennifer Hornung

Source: Perspectives in Health Information Management

Publication Date: January 2015

Abstract


Objectives: We introduce and evaluate a new, easily accessible tool using a common statistical analysis and business analytics software suite, SAS, which can be programmed to remove specific protected health information (PHI) from a text document. Removal of PHI is import....

Author: Asmonga, Donald D.

Source: Journal of AHIMA

Publication Date: January 2015

The wait for the second round of mandated privacy and security audits from the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) continues. OCR is currently working through final details for the revised audit plan as they await finalization of new technolog....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: November 2014

Don’t let the quiet before the storm fool you. Regulators might be hushed now, but compliance activity is expected to keep health information management (HIM) professionals on their toes throughout 2015. As electronic health record (EHR) implementation becomes more pervasive, so too does....

Author: Gordon, Lynne Thomas

Source: Journal of AHIMA

Publication Date: November 2014

It started with the Civil War.


When we think of the False Claims Act (FCA) today, headlines of healthcare billing fraud and abuse settlements may come to mind. But the Act actually goes back to 1863, when the US government found itself ill-served by contractors who were selli....

Author: U.S. Department of Health and Human Services. Office of the Inspector General

Source: Government (U.S.)

Publication Date: October 2014

This report forecasts areas of OIG focus based on the results of OIG’s risk assessments and have been identified as significant management and performance challenges facing HHS. In FY 2015 and beyond, we will continue to focus on emerging payment, eligibility, management, and IT systems security vulnerabilities in health care reform programs, such as the health insurance marketplaces.

Author: Huey, Kim

Source: CodeWrite | AHIMA newsletter article

Publication Date: October 2014

Evaluation and management (E/M) are cognitive services in which a physician or other qualified healthcare professional diagnoses and treats illness or injury. Almost all specialties will perform evaluation and management services. Even physicians who generate the bulk of their revenue in....

Author: Franklin, Janet

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: October 2014

There are three age-defined models under commercial risk adjustment. These are the Adult Model (ages 21 and up), the Child Model (ages 2–21), and the Infant Model (ages 0–1). The model applicable to a patient is dependent on their age at the end of the benefit year. If a 20-year-old patie....

Author: Bielby, Judy A

Source: Journal of AHIMA | Journal of AHIMA - Coding Notes

Publication Date: October 2014

A poorly managed coding process can thwart the effective use of coded diagnosis and procedure data. Take for example Hospital A, a fictitious hospital that does not effectively manage their coding processes. At this hospital, the coding professionals are concerned primarily with the impact....

Author: Wikina, Suanu Bliss

Source: Perspectives in Health Information Management

Publication Date: October 2014

Abstract


Data breaches arising from theft, loss, unauthorized access/disclosure, improper disclosure, or hacking incidents involving personal health information continue to increase every year. As of September 2013, reported breaches affecting individuals reached close to 27 milli....

Author: Hedges, Ron; Brady, Kevin

Source: Journal of AHIMA

Publication Date: September 2014

Every Health information management (HIM) professional, lawyer, and healthcare consumer should be familiar with the Health Insurance Portability and Accountability Act (HIPAA). For healthcare consumers, HIPAA offers protections and rights of access to personal health information. For HIM....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: August 2014

The HIM Problem: Medicare Auditor Scrutiny of Inpatient Claims


This spring, the Centers for Medicare and Medicaid Services (CMS) issued its “two midnight rule” which was intended to define and clarify what Medicare considers to be criteria justifying an inpatient st....

Author: Burton, Ben

Source: Journal of AHIMA

Publication Date: August 2014

Today’s healthcare organizations must field a constant bombardment of both new and evolving regulations that dictate how, when, or where patients may receive care. The changing regulatory landscape—combined with the fact that the government is recovering $16 for every dollar spent to comb....

Author: Cacciatore, Victoria; Downing, Katherine

Source: Journal of AHIMA

Publication Date: July 2014

Criminal attacks on healthcare systems have risen 100 percent since 2010, according to a recent Ponemon study.1 This makes it obvious that the privacy and security of patient health information is vulnerable and highly susceptible to data breach. The HIPAA Breach Notification Rule became e....

Author: Endicott, Melanie

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: June 11, 2014

Focus has been on training in ICD-10-CM/PCS for the past few years. With yet another delay, many organizations are slowing down their ICD-10 training and changing their focus back to ICD-9-CM.


The first quarter of 2014 was historic in “coder world” since t....

Author: Downing, Katherine

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: June 2014

The purpose of AHIMA’s new Breach Management Toolkit is to provide a comprehensive collection of resources and best practices to help healthcare organizations and health information management (HIM) professionals navigate their way through the Health Insurance Portability and Accountability Act (HIPAA) Breach Notification Rule and the overall breach management process. The toolkit is intended to raise awareness of the importance and responsibility of everyone within the organization to report HIPAA breaches to the appropriate designated personnel, as well as provide breach prevention education and training.

Author:

Source: Journal of AHIMA

Publication Date: May 2014

Many health information management (HIM) experts have wondered whether there is protected health information (PHI) on the black market. In short, the answer is “yes.” According to a 2012 Ponemon Institute study, 90 percent of healthcare organizations surveyed have had at least....

Author: Patten, Melinda; Profitt, Karen; Lucci, Susan

Source: Journal of AHIMA

Publication Date: April 2014

IN TODAY’S HEALTHCARE reform landscape, collaboration and care coordination have emerged as key pillars in the quest to improve the cost, quality, and access to healthcare in the US. As a result, organizations across the nation are entering formal and informal alliances designed to broade....

Author: Downing, Katherine

Source: Journal of AHIMA

Publication Date: April 2014

On January 25, 2013, the US Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) published the long-awaited HITECH-HIPAA Omnibus Final Rule in the Federal Register. As anticipated, the Omnibus Rule includes some of the most significant changes to patient priva....

Author: McNabb, Joanne; Rhodes, Harry B.

Source: Journal of AHIMA

Publication Date: April 2014

A Massachusetts man who was turned down for a job discovered that there was a false diagnosis of severe depression in his medical record. He ultimately learned that the information had been entered by a psychiatrist who was submitting fraudulent bills to insurers.


Elsewher....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: April 2014

Have a spare 32.8 million hours? The US Department of Health and Human Services (HHS) sure hopes so.


As noted in the Federal Register, that figure is the total number of hours the HHS Office for Civil Rights (OCR) estimated it would take all HIPAA-covered entities combined....

Author: Hicks, Andrew

Source: Journal of AHIMA

Publication Date: April 2014

Some healthcare business associates are still asking if HITECH-HIPAA impacts them. The answer is just as important to their affiliated healthcare providers.


Thousands of companies are now legally obligated to comply with the HITECH-HIPAA regulations because of their busines....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: April 2014

The HITECH-HIPAA Final Rule has changed the way healthcare organizations do business, and those with seats in the C-suite can’t afford to stay out of the weeds with the new regulations.


Daniel Solove, founder of the HIPAA training firm TeachPrivacy, and law professor at....

Author: AHIMA Work Group

Source: AHIMA toolkit

Publication Date: March 2014

This toolkit addresses planning, implementing, and maintaining a breach management process. It includes tools for goal setting, prioritizing developmental steps, determining roles and responsibilities, monitoring risk factors, and mitigation solutions.

Author: Walsh, Tom; Miaoulis, William M

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: March 2014

In a perfect world, access controls alone would ensure the privacy and security of electronic protected health information (ePHI). However, the complexities of today’s healthcare environment make it extremely challenging to limit access to the minimum information necessary that members of the workforce require in order to perform their jobs.

Author: Warner, Diana

Source: Journal of AHIMA

Publication Date: March 2014

A warning issued in 2013 by the Centers for Medicare and Medicaid Services (CMS) has come to pass. “Meaningful use” Electronic Health Record (EHR) Incentive Program audits have begun. The College of Healthcare Information Management Executives (CHIME) reported that out of their 1,400 member organizations, almost 100 received audit notices in October 2013, totaling six percent of membership. In order to protect incentive payments earned through the meaningful use program, organizations need to be prepared for every audit contingency and know exactly what to expect. Organizations also need to avoid common mistakes that could lead to an audit and follow best practices for staying compliant to meaningful use standards.

Author: Rose, Angela Dinh; Greene, Adam H

Source: Journal of AHIMA | AHIMA Q and A

Publication Date: March 2014

This article concludes a three-part series discussing the most commonly asked questions regarding compliance requirements surrounding the final HITECH Omnibus Rule, released in January 2013. It highlights the updated requirements and provides answers to questions regarding decedent protected health information (PHI), the release of immunization records to schools, and the enhanced request for restrictions requirements.

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: March 01, 2014

Health information management (HIM) professionals are too often witness to an array of fraudulent activities, whether its fraud via “upcoding,” improper disclosure of protected health information (PHI), or other breach activities.


Since reporting noncomplia....

Author: AHIMA Work Group

Source: Journal of AHIMA | AHIMA web extra

Publication Date: January 2014

Health information management (HIM) is a discipline that has rapidly evolved toward roles of increasing complexity and demand in recent years and the coding profession has been one area at the center of this growth. Even though the HIM profession is currently rethinking their coding and clinica....

Author: Crump, Dawn

Source: Journal of AHIMA

Publication Date: January 2014

Medicare's Recovery Audit Contractor (RAC) program began as a three-year, three-state pilot program in 2005 and went nationwide in 2009. The American Hospital Association (AHA) began tracking data collection in January 2010 and since then, according to AHA, the RAC program has recouped $2.....

Author:

Source: External web site

Publication Date: 2014

The HIPAA COW website provides resources for covered entities, business associates, and trading partners under HIPAA, as well as any other organization impacted by HIPAA regulations.

Author: Rihanek, Theresa; Lopez, Doreen

Source: AHIMA practice brief

Publication Date: November 2013

This practice brief supersedes the July 2011 practice brief "Understanding Governmental Audits."


Today, armed with enhanced fraud and abuse laws, the federal government has launched new audits that organizations and providers must contend with on a regular basis. Recent additions....

Author: Walsh, Tom

Source: AHIMA practice brief

Publication Date: November 2013

Editor’s note: This update replaces the January 2011 practice brief “Security Risk Analysis and Management: An Overview.”


Managing risks is an essential step in operating any business. It’s impossible to eliminate all threats; however, healthcare organizati....

Author: Walsh, Tom

Source: AHIMA practice brief

Publication Date: November 2013

Editor’s note: This update supplants the March 2011 practice brief “Security Audits of Electronic Health Information (Updated).”


In a perfect world, access controls alone would ensure the privacy and security of electronic protected health information (ePHI). How....

Author: AHIMA

Source: AHIMA practice brief

Publication Date: November 2013

This 2013 practice brief version has been retired and is retained here for historical purposes. Read the 2016 updated version of this Practice Brief here.



The Privacy Rule portion of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 defines a "business....

Author: AHIMA Advocacy and Policy Team

Source: Journal of AHIMA

Publication Date: November 2013

Although the First session of the 113th Congress is coming to a close, plenty of work remains for the members of Congress to accomplish in the coming year. AHIMA has worked closely with federal legislators to raise awareness on key initiatives that affect health information management (HIM....

Author: Downing, Kathy; Odia, Godwin

Source: AHIMA practice brief

Publication Date: November 2013

Editor’s note: This update supplants the 2009 practice brief “Redisclosure of Patient Health Information.”


Redisclosure is the act of sharing or releasing health information that was received from another source (e.g., external facility or provider) and made part....