Senate Investigates for-profit home healthcare

Reuters reports that the U.S. Senate Finance Committee is investigating four for-profit home healthcare agencies over billing practices that raise flags about reimbursement from the Medicare insurance program.

The Wall Street Journal recently analyzed that home healthcare agencies “intentionally increased utilization for the purpose of triggering higher reimbursements.”

LHC Group released a statement that it would comply with the senators’ request. Representatives for Amedisys, Gentiva and Almost Family could not be immediately reached for comment on the probe.

Click the links to read the full story.

Post your responses, we want to hear your thoughts on this story...

Important Coverage for Healthcare Providers

The New Medicare RAC (Recovery Audit Contracts)  and Current & Emerging Acts Put Health Care Providers at Risk!
Now effective in 49 states and will be effective June 01 in California

Health Care Providers, now need coverage protection for losses resulting from the current and emerging regulatory changes of the 21st century. These new government acts creat new sources of liability and finacial risk for health care providers.  The follwoing are just some the acts to be mindful of:

• EMTALA
• Redflag Rules
• HIPPA
• Hitech
• Medicare RAC Audits
• STARK
• Data Breaches
• Virus Attacks, and so on...

Dear Healthcare Providers,

As I’m sure you’re aware, times have changed in the health care industry and more changes are on the horizon. As an insurance agent that specializes in the health care industry, I have been monitoring the regulatory changes related to Medicare/Medicaid Recovery Audit Contractors (RAC) program, Privacy/Data Breaches, and other Medical Regulations (HIPAA, STARK, EMTALA, etc.). Your exposure for financial loss due to any of these regulations is growing. Many healthcare providers mistakenly believe that they are covered for these exposures under their professional liability policy. For the most part, there is probably little or no coverage under your professional liability.

Did you know?

• The average cost to defend a RAC audit is $80,000!
• RAC Auditors can use electronic automated reviews without accessing your physical files and they are not required to give you advance notice of the audit.
• Most billing errors are outdated codes or common mistakes. Fines and penalties can be assessed up to 3 times the recovery amount.
• Federal auditors recouped more than $900 million in improper Medicare payments from 2005 - 2008 in a pilot RAC program in just three states.
• President Obama has recently announced his support of expanding the program to allow these agencies to use recovered monies to fund their audit programs. Expectation is to recoup $2+ billion for taxpayers in the next couple of years.
• The Identity Theft Organization estimates that 20.5% of all data breaches occurred in health care provider organizations in 2008.

Since you are potentially at financial risk, I recommend we discuss your options for protection. We have a combined product offering which addresses many of the billing error, regulatory and cyber/privacy exposures you face in your company today. It is very affordable – starting at $2,250 for $1,000,000 in coverage.

Byrne - Kim & Associates Ins SVcs, Inc - is a full service insurance agency specializing in finding coverage solutions for health care providers like you.  We pride ourselves in being at the forefront of the issues that you face within your industry.  If you have questions or would like to discuss your coverage options further, please contact me at (949-249-2540 or paul@bkaainsurance.com)

heads up for all employers bill brings new heat on employee classifications

Employee misclassification

As you can imagine, increased enforcement of the Fair Labor Standards Act's employee classification rules wasn't enough. Now Congress is considering the Employee Misclassification Prevention Act.

 

In recent months, the Department of Labor has been talking about its efforts to crack down on employers who violate employee classification rules. But EMPA raises the stakes, both in terms of administrative requirements and penalties.

The proposal calls for:

• A requirement that employers provide each of their employees a written notice defining their classification
• 
  
• A new DOL “employee rights Web site,” which would explain how workers might have additional rights under state statutes and offer a link to file a complaint with the DOL’s Wage and Hour Division
• 
  
• Specific retaliation protection for employees who file wage-and-hour complaints with the feds
• 
  
• A new program under which the DOL and the IRS could trade evidence on misclassification allegations
• 
  
• Increased penalties on employers who misclassify workers or violate minimum wage or overtime regs. Penalties would be up to $1,100 per worker for first-time violators and up to $5,000 per employee for repeat offenders, and
• 
  
• Triple penalties for “willful” violations of FLSA rules.

  Source: HRMorning.com

  For more information on the proposal requirements & penalties and for the full story click here

  This new bill would effect industries especially Nursing Staffing Companies, Home Health Care Agencies,and many other industries.

 If you are not sure about if your staff are employee or independent contractor click here to get a better determination.

 Post your reviews and questions regarding this...

Bond Discounts

Byrne - Kim & Associates would like to announce of new service offer, we are now offering discounts on all bonds offered through our company, if we write the your packages too.

How it will work, if you are in a business that requires a bond, (surety, performance, etc)., we can offer your bonds a 20% - 30% discount, upon the agreement that we will also write your Liability and or workers compensation insurance also.  This is our package discount offer.

 For example if your a Home Medical Equipment dealer, you are required to have a DMEPOS Surety bond in  place, now if you renew your liability package and or workers compensation with our company you will then receive a 20% - 30% discount on your new or renewal bond.  In some cases you may be eligible for a free bond.  To see if you qualify for a free bond or would like to know more about our discount service and how it works.

Please contact Paul Byrne. 

Tel. 949-249-2540

Are you Hippa Compliant and Protected?

Most people believe that their medical and other health information is private and should be protected, and we want to know who has this information.


The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information.

The Privacy Rule applies to all forms of individuals' protected health information, whether electronic, written, or oral.

The Security Rule, a Federal law that protects health information in electronic form, requires entities covered by HIPAA to ensure that electronic protected health information is secure.

  

Who is required to follow these laws?

Health Plans, including health insurance companies, HMOs, company health plans, and certain government programs that pay for health care, such as Medicare and Medicaid.

Most Health Care Providers—those that conduct certain business electronically, such as electronically billing your health insurance—including most doctors, clinics, hospitals, psychologists, chiropractors, nursing homes, pharmacies, Home Health Agencies, Medical Equipment Providers and dentists.

Health Care Clearinghouses—entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa.

How Is This Information Protected?

Covered entities must put in place safeguards to protect your health information.

Covered entities must reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.

Covered entities must have contracts in place with their contractors and others ensuring that they use and disclose your health information properly and safeguard it appropriately.

Covered entities must have procedures in place to limit who can view and access your health information as well as implement training programs for employees about how to protect your health information.

Can I purchase Insurance for HIPPA Coverage?

Yes you can, available through Byrne - Kim & Associates we have available for entities such as the above:

HIPAA Protector and MEDEFENSE™ Plus

Eligibility: Organizations delivering direct medical or medically-related services.

Classes include, but are not limited to, the above.

Limits Available: Up to $1,000,000 each claim/$5,000,000 aggregate

Special Features:

HIPAA PROTECTOR - Defense costs and civil fines and penalties coverage for governmental HIPAA proceedings.

MEDEFENSE™ PLUS - Defense costs and civil fines and penalties coverage for Billing Errors, HIPAA, EMTALA and Stark proceedings.

• Full Prior Acts available
• Broad definition of Insured
• Broad definition of Billing Errors Proceedings to include both governmental and commercial payroll
• audits and investigations, qui tam plaintiffs, or voluntary self-disclosure
• Waiver of co-insurance upon selection of panel counsel
• Sub-limit available for Medical Board Proceeding defense cost reimbursement
• Payment for approved shadow audits

Visit: http://www.bkaainsurance.com/HippaMedefense.html

Liability Carrier for Home Health Agencies Lower their rates!!

News update, one of our A Rated Carriers has lowered their rates for General/Professional Liability Insurance for Home Health Agencies, Staffing Agencies, Companion Care Giver Agencies and Hospice Providers, to increase their client ratio.

Our Carrier is A-Rated admitted in most states, and is now offering Occurrence Form on the General Liability section, Claims Made also available if you wish to lower your rates.  (warning for those with claims made policies, before you switch to an occurrence form, check with your broker about obtainig a tail policy, it may pay to stay claims made).

$1,000,000/1,000,000, $1,000,000/$2,000,000 and $1,000,000/$3,000,000 limits available higher on a referal basis.
Variable deductible options.
Sexual Abuse Coverage Optional (recoomended)
Non-Hired Auto available (recommended)
Employee Dihonesty Bonds, also available starting at $350 and up.

Visits our site for more information www.bkaainsurance.com  or email paul@bkaainsurance.com

Contact #: 949-249-2540

Is your Written Safety Program in Operation and Compliant?

Certified OSHA Compliant Safety Plans:  -  “Is your written safety program in operation?” asked for on the Acord Supplemental Workers Compensation Application.

Labor Code 6401.7 (a) every employer shall establish, implement and maintain an effective written Injury and Illness Prevention Program (IIPP). These Safety Plans meet all the requirements for the current code.

Safety plans can help businesses avoid the minimum fine for a willful violation of $25,000 per occurrence. If the business is aware of a regulation and intentionally disregards or is indifferent to the regulation and OSHA can prove so they will be fined $25,000 no matter the size of the company.

Worker injury is a top concern of many American business owners, a new survey by The Hartford Financial Services Group reveals.  The research found that, when it comes to situations covered by insurance, three out of four businesses with up to 500 employees are either worried or very worried about workplace accidents.

Businesses' concerns about workplace injuries are not surprising, considering that 54 percent of the respondents have had at least one workplace injury in the past three years. Of those reporting accidents, 91 percent said they were worried  about future accidents. Interestingly, 73 percent -- nearly the same number of businesses that are worried about workplace injuries -- offer temporary alternative assignments to employees injured on the job who cannot perform their normal duties. But only one- third of those have a formal return-to-work policy.

Download your FREE OSHA Injury & Illness Prevention Program On-Site Self-Evaluation applicable for all states!

BKAA Insurance Services is offering all of our Visitors & current Cleints Safety Plans that address industry specific OSHA regulations and standards, so you can implement an effective safety program for your business.

We have identified the most common safety regulations a business is likely to encounter. The Safety Plans provided are tailored for your specific industry to address your individual exposure risks.

BKAA Insurance Services is here to serve our clients with the best resources in the marketplace. This proactive solution addresses the exposures your business faces every day. These exposures concern potential employee accidents that can affect your bottom line. Implementation of these safety plans can help control these exposures and reduce workers' compensation insurance costs.

50% OFF the Regular Retail Price!!

You can order this Certified OSHA Compliant Safety Plan through our special offer for only $300.00 (That’s a Savings of $300.00).  CLICK HERE for an application