Q: I was wondering if you know anyone with a standard patient confidentiality form for the new HIPAA rules A: Thanks for your question placed on my webpage. First of all the privacy portion of HIPPA will not be in effect until April 2003. We are actively in the phase of fraud review (although I doubt if it will immediately impact chiropractic offices in any substantial way unless the managed care programs require compliance). This fraud portion was the stimulus of my most recent e-mail titled "short sighted." The presence of a state board of chiropractic ruling or perceiving asymptotic care being fraud opens a new and dangerous chapter in our profession. Below is the notes from a portion of my seminar where I touch the HIPPA concerns. You will see the e-mail and webpage address of Dr. Brad Hayes. These notes come from his seminar. He has an updated compliance manual .. at least guidelines and a copy of his .. for a fee. I purchased a copy of the book and it is full of practical ideas that will assuredly have you in compliance when the time comes. I would contact his for the book if you wish. Have a Great Day Dr. M HIPAA Health Insurance Portability and Accountability Act Complying with the Government Fraud Compliance Manual Patient Privacy What is Health Fraud: "The Knowing and Willful Deception, Misrepresentation or Reckless Disregard of the Facts with Intent To Receive Unauthorized Payment" Fraud Prosecutions: False Claims Act (1963) .. Bounty Hunters ‚ 30% of recovered funds Investigative Steps: Record Review .. Patient Interview .. Staff Interviews Expert Interview .. CONFESSION Avoid Health Care Fraud: Provide Only Necessary Care .. Document Care .. Report Correctly What is Compliance: Policies and procedures designed to identify legal and regulatory problems, correct identified deficiencies and create a mechanism to prevent future problems Why implement a Compliance Program: Health care fraud is Dept. of Justices number one priority Compliance reduces potential penalty Avoids Bounty Hunters .. Opens channel of communication Staff interaction with procedures Implementing a Compliance Program: Conduct records audit and train staff Identify potential illegal conduct and corrections Minimum Program Standards: Overall program oversight .. delegate responsible person to oversee employee Training .. monitoring .. enforcement Ten Reasons For an Insurance or Investigative Audit: Failing to deal effectively with employee or patient complaint Giving away free services Structure of multi-disciplinary practice Failing to follow rules of third party payers Improperly coding, especially use of 99205, rehab and physical medicine Improper documentation to support billing Your advertising Using outside billing or collection services Failing to respond to "peer review" regarding medical necessity Maintaining on-going relationships with attorneys, consultants, labs Fraud Prosecutions: Billing for services not rendered Misrepresenting of the nature of services provided Providing unnecessary and/or substandard services Misrepresenting the service by the provider HIPAA Compliance Manual Assistance: Dr. Brad Hayes: DCBRAD1@AOL.COM www.chiropracticcomplianceconsultants.com Seven Steps to Practice Compliance: Audit and monitor Establish practice standards and procedures Designation of compliance officer Conduct appropriate training and education Respond to detected offenses and offer corrective action Develop open lines of communications Enforce disciplinary standards through publicized guidelines Patient Privacy: April 2003 Concerned Area: Consent Forms .. patient sign new privacy consent forms with HIPAA Authorization .. to use patient info for marketing or research Privacy Policy Notice .. placed in office for patients to review Minimal Disclosures .. when consulting with another provider Computer Security .. passwords .. access to info .. disposal of data Site Privacy and Security .. locked records and difficult to view records Business Associates .. independent contractors .. consultants .. billing services .. record transcription services .. radiology and diagnostic labs .. vendors who send supplies with patient¼s name enclosed .. cleaning service if records are accessible .. accountant .. lawyer (except PI when their client is involved) Training .. your staff and retrain them periodically. Small office discuss Marketing .. authorization needed to use patient name Documentation .. provide written documentation of compliance of above Worker¼s Compensation and Personal Injury .. presently exempt Patient¼s Rights .. confidentiality and access of their records Legal Questions Concerning HIPAA Compliance: John Pieck, JD at: Jpeick@peick-usa.com