them. When you get the complaint, it al- ways sounds bad until you get the other side of the story.”
OIG will continue to step up its en-
forcement efforts with the new hires across the board, Mr. Wilson says, noting that the new law requires background checks of anyone owning at least a 5-percent stake in a practice accepting Medicaid patients.
During the 2013 legislative session, TMA won passage of legislation to im- prove due process of OIG fraud inves- tigations for physicians and make the agency’s investigative and payment-hold processes more transparent. TMA took the issue to the legislature after HHSC adopted “program integrity” rules physi- cians couldn’t live with. (See “Fighting for Fairness,” August 2013 Texas Medi- cine, pages 35–38.)
Looking for big buck country?
HIPAA compliance help from AMA, TMA
The American Medical Association has a toolkit to help physicians navigate the sweeping new revisions to the federal privacy and security rules for health in- formation that took effect Sept. 23. The U.S. Department of Health and Human Services issued a final rule in January that revises and extends HIPAA safeguards for protected health informa- tion (PHI). The rule expands the indi- vidual rights of patients, including tight- ening requirements on physicians when patient information is breached. As a re- sult, physician practices could face more legal scrutiny and higher fines in case of an information breach. The AMA toolkit provides guidance to help physicians review and update their existing HIPAA policies and procedures with an easy-to-understand breakdown of the revised rule, including encryption safeguards for electronic patient infor- mation. Physicians will need revised pri- vacy notices to share with patients, as well as new agreements with business associates that handle patient data. AMA
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