PICA Insights

Cultural Awareness and Competence in Healthcare

Nov 7, 2022 1:25:21 PM / by PICA Risk Management Specialist posted in Risk Management, Practice Management

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While most healthcare providers are compassionate and want to provide optimal care to their patients, everyone has biases and knowledge gaps that may hinder the provision of quality healthcare. These biases and knowledge gaps can lead to:

  • Barriers to care
  • Miscommunications
  • Misdiagnosis
  • Lack of trust

As the United States continues to become more diverse, cultural awareness and competence are key for healthcare providers.

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Handling Patient Refunds the Right Way

Sep 8, 2022 12:03:22 PM / by PICA Risk Management Specialist posted in Risk Management, Practice Management

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Finding yourself in a situation where a patient is unhappy with their treatment and asking for a refund, what should be your response? For example, you may feel that your work is satisfactory, and you are unwilling to provide a refund to the patient considering all the time you spent on their care. Or you may be seeking a quick resolution to the situation. In this article, we’ll take a closer look at how to handle patient refunds.

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Skin Substitute Rebate Compliance Requirements for Doctors under the Anti-Kickback Statute and Safe Harbor Regulations

May 27, 2022 11:41:42 AM / by J. Kevin West posted in Risk Management, Claims

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Written by: J. Kevin West & Jamie L. Riley

PICA has become aware of situations in which vendors of skin substitute products offer rebates to doctors who purchase those products. Questions have arisen regarding what legal requirements, if any, are doctors required to comply with to ensure that any rebate payments received do not subject a doctor to the criminal or civil penalties in the Anti-Kickback Statute (AKS).

The AKS imposes criminal and civil penalties if a doctor knowingly receives any remuneration in return for purchasing or ordering any item for which payment may be made by a federal healthcare program, such as Medicare. In short, the AKS prohibits kickbacks between doctors and vendors. “Remuneration” under the AKS specifically includes rebates. However, the AKS contains an exception for certain “discounts” if the discount is properly disclosed and appropriately reflected in the costs claimed or charges made by the doctor to Medicare. This exception is commonly referred to as a “safe harbor” provision.

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Cybercrime Claims Scenarios: Can These Happen to You?

Apr 19, 2022 3:20:58 PM / by PICA Risk Management Specialist posted in Risk Management, Claims

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In a word, yes. Many podiatrists significantly underestimate how much a breach will cost, and think they can self-insure it. Outlining what will happen in the event of a breach is very useful when understanding the value of cyber liability coverage. Below are a variety of claims scenarios that help illustrate the severity of cyber claims, and how widespread cyber breach activities are throughout the healthcare industry.

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