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Free Consultation at AAPPM November Meeting
The best way to avoid a HIPAA breach is to keep up with what is new.

We would like to offer you a free HIPAA readiness consultation with Tahlia, our VP of client services. To schedule your appointment click on the Orange Button Below.

HIPAA Risk Assessment is a Federal Requirement
Every practice is required to update their Risk Analysis and Risk Mitigation Plan at least annually or more often if changes warrant an update. What does this mean for your practice?

Changes that require an update of your Risk Analysis include:
  • Updating the computers in your practice
  • Updating the routers or other network equipment in your practice
  • Adding or changing any of the software you use in your practice
  • Adding a new digital imaging system to your practice
  • Moving your practice to a new location.

So even if your risk analysis is less than 1 year old, if you have had any of the changes listed above you need to update your Risk Analysis and generate a new Risk Mitigation plan.

But 'What if there have not been any changes to my practice in the past 12 months.. Why do I have to update my Risk Mitigation Plan?'

That is a very good question. The answer is simple. Just because there have not been any changes inside your office, the threats to your office have changed in the past 12 months, and the tools you can utilize to combat those threats has also changed for example:

  • As little as 5 years ago encryption technology was difficult to use and expensive so you were not required to encrypt your computers. It is now easy to use and inexpensive so the Federal Government expects you to have your computers encrypted.
  • As little as 3 years ago Ransom Ware was not an issue for Podiatry Practices. It is now a huge problem and you need to have protection in place to prevent Ransom Ware from hitting your practice and you need a disaster recovery plan should you become infected with Ransomware.
  • As little as 1 year ago the security on wireless routers was considered Rock Solid. In the past year there have been numerous vulnerabilities discovered with commercial routers and if you have not updated your router firmware your practice may be at risk of a cyber attack.
Updates from TLD Systems
Security Updates

The items below are an example of just two of the recent vulnerabilities that may impact your practice. Each week many more are discovered. At TLD Systems we keep you up to date with all known issues and work with your IT staff to keep your practice protected..




Cross-site scripting (XSS) vulnerability on D-Link DIR-615 routers 20.07 allows attackers to inject JavaScript into the router's admin UPnP page via the description field in an AddPortMapping UPnP SOAP request.



On Dell 2335dn printers with Printer Firmware Version 2.70.05.02, Engine Firmware Version 1.10.65, and Network Firmware Version V4.02.15(2335dn MFP) 11-22-2010, the admin interface allows an authenticated attacker to retrieve the configured SMTP or LDAP password by viewing the HTML source code of the Email Settings webpage. In some cases, authentication can be achieved with the blank default password for the admin account. NOTE: the vendor indicates that this is an "End Of Support Life" product.
Upcoming TLD Systems Webinars
Annual Training for Doctors and Staff

Included in our services are educational webinars for your staff

HIPAA requires that all staff members who come into contact with patient information have annual training. We provide this training free to all of our clients.

If you have a new employee they must be trained within 30 days of starting work. Employeed who have had previous training need to have repeat training annually.

This training webinar is presented monthly so that your office can stay compliant with this HIPAA regulation.

Upcoming Training Webinars:


Thursday November 15, 2018 at 8:00 PM Eastern
Monday December 3, 2018 at 1:00 PM Eastern
Thursday December 20, 2018 at 7:00 PM Eastern

Security Updates







Google has released Chrome version 69.0.3497.92 for Windows, Mac, and Linux. This version addresses vulnerabilities, one of which an attacker could exploit to take control of an affected system.



Microsoft has released updates to address multiple vulnerabilities in Microsoft software. A remote attacker could exploit some of these vulnerabilities to take control of an affected system.


Adobe has released security updates to address vulnerabilities in Adobe Flash Player and ColdFusion. An attacker could exploit some of these vulnerabilities to take control of an affected system.


When your computer is accessible through an internet connection or Wi-Fi network, it is susceptible to attack. However, you can restrict outside access to your computer—and the information on it—with a firewall.


CMS and Carrier Updates
Physician Fee Schedule Year 3 Proposed Rule: Comments due September 10

Reminder On July 12, CMS released proposed changes to the Physician Fee Schedule and Quality Payment Program. CMS seeks comment on various proposals by 5 pm ET on September 10. See the proposed rule for more information.

To submit Comments:

1. Electronically. You may submit electronic comments on this regulation to http://www.regulations.gov. Follow the “Submit a comment” instructions.

2. By regular mail. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1693-P, P.O. Box 8016, Baltimore, MD 21244-8016.

Please allow sufficient time for mailed comments to be received before the close of the comment period.

3. By express or overnight mail. You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1693-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

MIPS Targeted Review Request: Deadline October 1

If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback are available on the Quality Payment Program website. The payment adjustment you receive in 2019 is based on this final score. If you believe there is an error in your 2019 MIPS payment adjustment calculation, request a targeted review until October 1 at 8 pm.

For More Information:

Contact the Quality Payment Program at 866-288-8292 (TTY: 877-715-6222) or [email protected]


The 2019 Medicare and You Handbook includes information on the Medicare Diabetes Prevention Program, a new Medicare-covered service. Help your patients prevent or delay Type 2 diabetes and understand their treatment options. During this call, learn about the service, eligibility requirements, and how to refer your patients. A question and answer session follows the presentation.n updated based on calculations from the first snapshot of data from APM entities.



The Centers for Medicare and Medicaid Services (CMS) is always looking for better ways of protecting Medicare provider and Medicare patient information. CMS recently provided additional security requirements for Palmetto GBA's eServices portal. Please read this article to find out the latest changes and share with appropriate staff.


Palmetto GBA would like to encourage our provider community to attend an upcoming KEPRO, the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) Person and Family Engagement (PFE) webinar on Tuesday, September 25, 2018, at 2 p.m. ET. Please share this announcement and registration information with your staff. e with appropriate staff.

Each year, Medicare providers are required to recertify their Direct Data Entry (DDE) / Professional Provider Telecommunication Network (PPTN) User access. The re-certification deadline for Part B PPTN Users is September 30, 2018.


Currently, myCGS provider administrators and users are required to log into the portal at least once every 60 days to avoid access being deactivated. To ensure compliance with recent CMS security changes, this inactivity time frame is changing from 60 days to 30 days.

This change will be implemented September 8, 2018. Therefore, if you have not logged into myCGS within the past 30 days your access to myCGS may be deactivated.


The DME Provider Outreach and Education team has scheduled a Comprehensive Workshop in Atlanta, GA, on September 26, 2018 at the Mansour Conference Center in Marietta. This workshop is open to all suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies DMEPOS in Jurisdiction C.

Ever wonder what an auditor looks for in your documentation? Are you aware of the newest information from Medicare and how it affects your company? Are you challenged with navigating through your initial claim determinations and taking the next step towards resolution? All of these topics, as well as the top error rates and error-prone equipment categories for Georgia suppliers will be covered at the workshop.

There is a $75 registration fee for the workshop, but that fee covers the workshop booklet, ancillary materials, and everything you will need during the day.
Click here to register for the workshop!
In Person Events

Visit the online course catalog in the Learning Center to view all of the live educational opportunities available and to register for these events.

Overlaps

Reducing Overlapping Claims (Part B) - A Collaborative Effort Between WPS GHA and NGS
09/11/2018 - Holyoke, MA - 12:30 PM - 4:00 PM ET
10/23/2018 - Glen Ellyn, IL - 12:30 PM - 4:00 PM CT

Overlapping claims continue to be a top claim rejection for providers. Often, overlapping claims can be prevented by knowing how to properly submit claims in these situations. WPS GHA and NGS would like to invite all Part B providers (billing on a 1500) to join us in this unique joint event to collaborate and learn with the MACs processing your claims and help reduce your workload.

Reducing Overlapping Claims (Part B)
10/09/2018 - Springfield, MO - 12:30 PM - 4:00 PM CT

Overlapping claims continue to be a top claim rejection for providers. Often, overlapping claims can be prevented by knowing how to properly submit claims in these situations. WPS GHA would like to invite all Part B providers (billing on a 1500) to join us in this event to collaborate with other providers and learn how you can reduce your workload.

Skilled Nursing Facility

SNF Consolidated Billing - A Collaborative Effort Between WPS GHA and NGS
09/12/2018 - Holyoke, MA - 9:00 AM - 4:00 PM ET
10/24/2018 - Glen Ellyn, IL - 9:00 AM - 4:00 PM CT

Do you want to become a "pro" and the go-to person in your office for questions related to SNF Consolidated Billing? WPS GHA and NGS have come together to provide this unique, interactive event for our provider communities. You will learn all the intricacies of SNF Consolidated Billing during this INTENSIVE day of hands-on training to help you implement strategies and tools needed to become your office's subject matter expert.

SNF Consolidated Billing
10/10/2018 - Springfield, MO - 9:00 AM - 4:00 PM CT

Do you want to become a "pro" and the go-to person in your office for questions related to SNF Consolidated Billing? This is a unique, interactive event for ALL PROVIDERS affected by SNF Consolidated billing. You will learn all the intricacies of SNF Consolidated Billing during this intensive day of hands-on training to help you implement strategies and tools needed to become your office's subject matter expert.
Adjusted Claims Denying for Ordering/Referring Provider


Provider/Supplier Type(s) Impacted: Not Applicable

Reason Codes: Not Applicable

Claim Coding Impact: Procedure/HCPCS with TOS 3, 4, or 5 that require a referring/ordering NPI.

Description of Issue: Adjusted claims are denying in error for referring/ordering provider because the information on the original claim is not transferring to the adjusted claim. Since the claims were originally paid, overpayments are occurring and must be refunded.

Noridian Action Required: Adjustment regions will suspend and will be manually reviewed for the referring/ordering information. If the original claim had the appropriate referring/ordering data submitted, this data will be manually input onto the adjustment. This will allow the adjustment to process without denying for missing referring/ordering data.

Provider/Supplier Action Required: Provider will want to follow the regular recoupment process and await payment from the mass adjustment.

Proposed Resolution/Solution: A fix is being installed into Production on 08/03/18 to resolve the issue. Once in Production, mass adjustments will be done to re-open any adjustments denied in error.

08/06/18 - On 08/03/18, the fix for this issue went into production and a mass adjustment was run. On 08/06/18, the claims processing system was updated to no longer suspend adjustment regions.

08/16/18 - A second mass adjustment will be run to identify any claims not yet adjusted.

Date Reported: 07/13/18

Date Resolved:

Last Updated Aug 20, 2018

This special edition article (SE 18011) presents a current overview of the diabetes supplies covered by Medicare (Part B and Part D) to assist physicians, providers, suppliers, and other health care professionals who provide diabetic supplies to Medicare beneficiaries. This article is informational only and represents no Medicare policy changes.

The Medical Review Claims feature in Novitasphere can be used to perform a search of claims selected for targeted probe and educate (TPE). Detailed information regarding the topics for review is posted to the Medical Review – Targeted Probe and Educate webpage. Novitas will notify providers in writing of the TPE topics being reviewed, the reason for selection and the process for the review, including Additional Documentation Requests (ADRs). Once an ADR is sent, Novitasphere customers can search based on the case number, claim control number, Medicare Beneficiary identification number, documentation response status or date.

Additional activity related to the claims selected for Medical Review with an ADR development will be updated as the activity is completed. The Medical Review Claims will display the following information:

   Additional Documentation Request Information will display the date the letter was sent, due date, receipt date, and a PDF of the ADR.
   Review Information will display the date the MR review begins, date the review is completed, review outcome, review findings and the date the Review Results letter is sent.
   Education activity is displayed as the activity is completed. The type of education is displayed, as well as the date the education was completed. Each time an education is provided, this field will update with the most recent activity.

The Medical Review Claims feature should not be used to check the status of a claim that was not selected for medical review.
NGS October Virtual Conference

Registration is Now Open for the NGS October 2018 Virtual Conference!requirements, and how to refer your patients. A question and answer session follows the presentation.

The National Government Services (NGS) Provider Outreach and Education (POE) Team will be holding a second bi-annual virtual conference on Tuesday, 10/9/2018 and Wednesday, 10/10/2018. This two full-day virtual conference will offer a variety of Part B, Part A, FQHC and self-service sessions. There are no associated charges for this virtual conference, and you may register for as many sessions as you'd like.

Part A and FQHC
Part B
Part A, FQHC and Part B
Self-Service
The August issue of the United Healthcare Bulletin is available. Among the articles are:

  • New Smart Edits Deploying on Aug. 16 and Sept. 10
  • Pharmacy Update: Notice of Changes to Prior Authorization Requirements and Coverage Criteria for UnitedHealthcare Commercial and Oxford
  • Reminder on Special Needs Plan Model of Care Training
  • Revision to Durable Medical Equipment, Orthotics and Prosthetics Multiple Frequency Policy
  • UnitedHealthcare Medicare Advantage Plan Reimbursement — New Policies
  • Reminder: National Drug Code (NDC) Requirement Policy
  • Soon, you’ll need an Optum ID to access OxfordHealth.com.

To read the full bulletin visit the UnitedHealthcare Online Website.
FDA Updates
Recalls









Safety Alerts



Recent Medical Device Recalls



November 30 - December 2, 2017
San Antonio, TX
November 8-10, 2018
St Paul, MN
November 30 - December 2, 2018
Chicago, IL
January 15 - 24, 2019
Azamara Journey Ship (cruise)
February 7 -9, 2019
Tahoe, CA
February 7 - 9, 2019
Park City, UT
February 21 - 23, 2019
Atlanta, GA
March 29 - 31, 2019
Little Rock AR
April 11 - 14, 2019
Tysons Corner, VA
April 11 - 14, 2019
Phoeniz, AZ
April 25 - 28, 2019
Newport, RI
TLD Systems | (631) 403 6687 |  [email protected]  |  tldsystems.com