Clinic Refused Service to HIV Positive Patient

A St Louis eating disorders clinic has settled a claim for $140,000 after refusing service to a HIV positive patient.

Castlewood Treatment Center had delayed an applicant for months before suggesting she could be admitted if she had blood drawn offsite.

FTCA clinics should be mindful of the rise in these types of claims and require all employees to participate in anti-discrimination training. Contact today to discuss better protecting your organization from the costs of litigation.

Clinic Suit Dismissed Over Birth Control Mix Up

A West Bend Wisconsin couple sued a local clinic when the woman conceived a child after being given prenatal vitamins instead of birth control pills. The 2nd District Court of Appeals dismissed her claim for the cost of raising the child but will allow a new suit for pain & suffering plus lost wages.

Contact today to discuss better protecting your community health center against mistakes and the costs of litigation.

Smallest Data Breach Penalty Yet

The Department of Health and Human Services Office for Civil Rights reached its first settlement for a breach of patient information involving less than five hundred individuals. The Hospice of North Idaho has agreed to pay a $50k penalty to resolve allegations that it violated the HIPAA Security Rule when an unencrypted laptop was stolen with information on 441 patients. The settlement agreement is here. The penalty does not include the related public relations, investigation, legal or notification costs.

Almost all health care providers are required to report loss of identifiable patient information to HHS, contact us to discuss the specific requirements and risks.

Health Centers are being pressed with increasing financial risk at a time when margins are being squeezed ever tighter. Contact us today to discuss ways to broaden your current insurance coverage to address these growing concerns.

$1.5M HIPAA Settlement

A Massachusetts physician group has agreed to a $1,500,000 HIPAA fine after losing 3,621 patient records contained on a stolen laptop. This is a the second loss of records by the organization.

The restitution is payable over three years, the agreement is here.

Insurance coverage has become readily available for costs incurred from losses of patient data, with increasing regulations many healthcare organizations find it increasing affordable to insure against complying with increasing regulations.

Contact to better protect your organization.

RAC Audits Getting More Aggressive

It’s no surprise that government funded healthcare is under increased regulatory scrutiny, especially billing practices. RAC auditors are finding new and novel ways to charge back claims. A report from the AHA cites a 24% increase in denied claims this quarter over last.

Contact today to discuss better protecting your organization against unexpected and costly investigations.

Employment and Social Networks

On August 1st, the Illinois Governor made into law H.B. 3782. This new law addresses how a company can use social media websites in the hiring process. The law now prohibits an employer from asking a potential employee for their social networking password, username or other details. Growing in use and importance, social networking is being used more frequently by hiring departments when evaluating a candidate for employment. When using social media websites in the interviewing process, Calculated Risk Advisors urges firms to use caution. It is an important first step to obtain employment practices liability insurance and to seek counsel from a law firm specialized in employment law. Contact us today for additional information on ways to protect your firm from lawsuits.

Top Executive Liabilities for FTCA Insured Clinics

Facing an uncertain healthcare environment one thing is for sure, providers are confronted with regulation and oversight. The following list is a guide for issues any governmental funded clinic should be concerned with:

• False Claim Act allegations – Recent investigations have focused as much on minor kick backs (gift cards, free transportation, etc) to Medicare/Medicaid patients as they have to organizations who do not report and return overpayments.
• Wage and Hour claims – Plaintiff attorneys are filing suits alleging systematic unpaid overtime, employee misclassification, and failure to pay minimum wage. These have been especially prevalent in the healthcare industry where missed breaks and unexpected overtime are common.
• RAC Audits – The third party investigators have mainly focused on the largest and most profitable organizations but anyone accepting Medicare/Medicaid is at risk of fines.
• Anti-Trust – Mergers and Acquisitions are the main driver of Anti-Trust actions in healthcare. Reform is encouraging providers to combine to obtain economies of scale and a broader range of services, at the same time the FTC is strongly fighting many proposed non-profit tie ups.
• HIPAA/Hi-Tech compliance – Recent changes in laws are upping responsibilities and penalties for health care providers who lose patient information.
• Discrimination charges – Not a new issue but settlements and verdicts are on the rise once again.
• Wrongful Termination allegations – An uncertain economy and trouble in the job market is causing many dismissed employees to seek monetary relief wherever possible.
• Employee Theft – The complex contracting of health care not-for-profits is fertile ground for fraud and abuse of accounting controls.

Contact us today with any questions concerning these issues or to better protect your organization.