News & Events

(Sunday, June 2, 2018) CEO Stamm Joins Mayor De Blasio in New York’s 2018 Israel Day Parade

CEO Stamm Joins Mayor De Blasio in New York’s 2018 Israel Day Parade

 

As he does every year, Joseph Stamm attended the Israel Day Parade.  This year MedReview’s chief executive had the honor of marching alongside his long-time friend, Mayor Bill de Blasio in New York’s annual “Celebrate Israel Parade,” which took place on June 3 and marked seven decades of Israel’s statehood

Other dignitaries at the head of the parade included NYS Governor Andrew Cuomo, Israeli Ambassador to the UN Danny Danon, Israeli Consul General, NYC Public Advocate Trish James and many City Council members, Assembly members and Congressman.

A thousand NYPD officers guarded the marchers and the throngs of supporters along the parade route.

 

 

                         

 

 

 

 

 

 

(Monday, May 7, 2018) MedReview Achieves Gold Standard in Secure Technology With HITRUST Certification and a Seat on Panel of Cyber Experts

MedReview Achieves Gold Standard in Secure Technology With HITRUST Certification and a Seat on Panel of Cyber Experts

 

NYCHSRO/MedReview’s growth projections for 2018 got a significant boon just before the New Year with our certification as a HITRUST healthcare organization. The Health Information Trust Alliance, comprised of IT and security personnel of major organizations nationwide, grants this certification to entities who have demonstrated that all necessary security is in place to protect any personal healthcare information coming over the transom, electronically or otherwise. Notification of our HITRUST status followed a yearlong effort by two dozen staffers under the direction of SVP of Operations Spencer Young and CTO Dan McNamara to meet the rigorous demands. In March, on the heels of this success, CTO McNamara joined a trio of IT experts for a panel discussion on “AI for Cyber Defense” at the invitation of Darktrace, a noted San Francisco-based cybersecurity solutions provider for healthcare, biotech and pharma.

Since the advent of HIPPA in 1996 and the coining of the term PHI—protected health information—the business of healthcare in the technological age has been hit by continuing waves of regulations concerning the secure transfer and storage of patient information and medical records, including payment history. These regulations govern how we share such information down to the minutest identifiers, such as zip codes; vehicle and license numbers; web addresses; biometric identifiers such as finger, eye, and voiceprints; and any unique identifying number, characteristic or code except the unique code assigned to code the data. You read that correctly: new code configured to disguise existing code. The reality is beyond Orwellian.

In fact, HITRUST certification is the highest security clearance granted within the healthcare industry and related cloud-based businesses, including Amazon. “The HITRUST Alliance leads the charge,” states CTO McNamara. “It’s the gold standard.”

To achieve the title, a dedicated team from MedReview’s IT bullpen had to build and test complex new infrastructure while a second team from the executive suites, with a critical assist by WeCARE Program Director Debra Rush-Murphy, wrote and rewrote policies and procedures to ensure compliance. The infrastructure team alone included eight staff, two of whom were new hires specifically brought in to achieve and maintain HITRUST compliance.

“Our tech team supports, configures and manages IT—from the workings of the keyboard on your desk to corporate security,” McNamara explains.  “Reviewers, human resources, operations, clerical staff, chief officers—every end user at MedReview had to change the way they work. On-site third-party assessors went through our documentation to confirm that we had implemented mandatory password requirements, PHI clean-desk policies and other controls. HITRUST impacts every employee, no matter their job,” the CTO states.

Moreover, as rigorous as the requirements are, the Alliance moved the goal line just as MedReview was rounding to the finish. Ten days before our due date, the Alliance issued new controls, including rewritten versions of the original 180 plus 80 more.  “We had to redo it all from scratch,” McNamara states, “but our process had been so orderly we completed our updates in a month.”

SVP Young also commented on the rigor of the twelve-month application process. “The HITRUST Alliance did not conceive the designation with small or medium-sized businesses like ours in mind,” he said. “At times, we had to work backwards, figuring out how we did a task step by step in order to write procedures, or acquire new hardware because our infrastructure did not support their requirements.”

One of the most significant upgrades mandated under HITRUST rules was the creation of a disaster recovery site off premises, which must function as an exact duplicate of the security infrastructure at Water Street.  “We had to run tests to ensure that if one site crashes, all current data is saved at the other site, and vice versa,” Young explains. We had to bring down the entire system intentionally and bring it back up again. And, we had to achieve a specific minimum score to pass.”

NYCHSRO/MedReview succeeded in scoring very high marks with only minor findings that were easy to correct. Nevertheless, the work continues, as HITRUST certification is renewable biennially via the identical steps, plus any new specifications. “We start the application process all over again in 2019,” states McNamara.

Still, he is undaunted.

“We have built a really robust security program and we work hard to maintain it, so it will never be as difficult again,” he asserts. “It’s turned us into a security-first organization. We are exemplary to other organizations big and small. We are doing a better job at security than some major hospitals and financial institutions.”

An added bonus for all this work, notes MedReview’s CTO, is the well-earned allure our HITRUST status provides in the marketplace. His invitation to speak on Darktrace’s expert panel is one such example. The exclusive event moderated by Nicole Eagan, CEO of Darktrace and winner of the World Economic Forum Technology Pioneer Award, addressed security challenges in the healthcare sector and the use of artificial intelligence on the “frontlines of the battle” to detect ransomware and cyber threats. McNamara’s co-panelists were IT directors for Metropolitan Pathologists in Colorado and Country Life Vitamins in New York.

“As a customer, MedReview uses Darktrace technology as a way to incorporate machine learning into our own cyber defense efforts,” says McNamara. “This enables us to remain on the cutting edge as we maintain HITRUST requirements without employing additional staff.”

Our rising profile as a HITRUST healthcare company provides another boon to MedReview’s bottom line.

“We had been working for five years to win a DSRIP contract with one of New York’s largest and most prestigious medical centers.  Their decision-making process includes a risk assessment, and after receiving our official notice, I let them know that we are HITRUST certified,” says CTO McNamara. “The person on the other end said, ‘That’s all you had to tell us.’ Our new contract came through shortly after.”

(April 27, 2018) NYCHSRO/MedReview Celebrates Two Historic Achievements: Client Activity in All 50 States and Beyond plus Round-the-Clock Operations

 

NYCHSRO/MedReview Celebrates Two Historic Achievements: Client Activity in All 50 States and Beyond plus Round-the-Clock Operations

 

This time last year, NYCHSRO/MedReview announced the imminent expansion of our business to all fifty states, British Columbia, Puerto Rico and the Virgin Islands and, with it, the expansion of our full-floor of offices at 199 Water Street to a second office suite at 80 Pine Street—reflecting the company’s burgeoning client base and workforce. One year later, CEO/President Joseph Stamm is pleased to announce that now MedReview not only is operational throughout the US, as forecast in 2017, but that the company’s growth spate continues unabated through first quarter 2018.

As he marks his 43rd year at the helm of the organization, Mr. Stamm speaks with a well-earned sense of accomplishment. “It is been a longtime dream of mine to see the map of the US all in yellow, signifying MedReview’s activity throughout the American continent. This year, with the backing of the Board, my dream is reality,” he declares. “What began as a citywide business is now nationwide and beyond.”

Indeed, with this dream fully realized, Mr. Stamm has announced the achievement this quarter of yet another milestone:  MedReview’s giant leap into yet a third new office complex—this one, a newly constructed 100-person call center in the Philippines. As of press time, it is already up and running 24/7 with 45 operators fielding patient precertification requests on behalf of United Health Care and other clients. Built to MedReview’s stringent specifications, the call center is under the direction of EVP/CFO Helen Mutchler, a 36-year veteran of this organization and a native of the Philippines who travels there frequently to visit family from her home in the New York area.

“There is a twelve hour time difference between New York and the Philippines, so even when our offices here are closed at night and on weekends, our call center in the Philippines is fully staffed and fielding queries round the clock,” CEO Stamm explains. “Our goal is to provide the most cost-effective and efficient service possible to our clients.  Now patients from anywhere can get answers to questions or expedite a request anytime, day or night.”

(April 9, 2018) The Grab for Dollars: Decoding the Upcoding MedReview’s Case Study in Endoscopic Drainage

The Grab for Dollars: Decoding the Upcoding MedReview’s Case Study in Endoscopic Drainage

 

A 62-year-old male hospitalized for a duodenal ulcer with hemorrhage required a colonoscopy as part of his workup. During the procedure, the endoscopist noted that there was fecal material blocking the scope’s field of view and used the endoscope’s irrigation system to flush the material out of the way. Upon the patient’s discharge, the hospital added to its diagnostic and procedural coding for this case the code for “therapeutic lavage and drainage of the colon.” This DRG carried a charge of $71,000, or $35,000 more than the bill would have been without the upcoding.

“It is routine during a colonoscopy to lavage with water when visualization is impaired. Scopes have built-in water irrigation systems for just this reason,” states Seth Lewin, MD, Chief Medical Officer at MedReview. “Irrigation during endoscopy to better visualize the bowel in order to obtain an accurate diagnosis is routine and should not be billed as if it were a treatment separate and distinct from the diagnostic endoscopy.”

NYCHSRO/MedReview denied the additional coding for endoscopic lavage and drainage, reducing the billable DRG amount to $36,000.  The hospital doctors appealed, but the reviewers upheld our original coding.

“Attempts such as this to obtain enhanced payment for patient care are far from uncommon,” notes Dr. Lewin.  “In this instance, the effect of the upcoding was to nearly double the billed amount. MedReview recently reported a similar case in which the hospital coded administration of daily eye drops to a patient each morning as if it were an operative procedure, increasing the DRG payment by $2500. In the current instance of upcoding for therapeutic lavage and drainage of the colon, the cost impact was fourteen times as great and was equally and absolutely unjustifiable.”

[BOX:]

ORIGINAL BILL:                 $71,000.00

RECODED BILL:                  $36,000.00

CLIENT SAVINGS:             $35,000.00

(Wednesday, April 4, 2018) IRS Dirty Dozen: Watch Out for these 12 Scams 

Issue Number:    IRS Tax Tip 2018-52

IRS Dirty Dozen: Watch Out for these 12 Scams 

The IRS reminds taxpayers to watch out for scams and schemes that put them and their personal information at risk. Each year, the IRS releases the top 12 scams, known as the Dirty Dozen. The schemes run the gamut from simple refund inflation to technical tax shelter deals.

Here’s a recap of this year’s Dirty Dozen:

  1. Phishing: Taxpayers should watch for fake emails or websites looking to steal personal information. The IRS will never initiate contact with taxpayers via email about a bill or tax refund. Don’t click on links in these emails claiming to be from the IRS.
  2. Phone Scams: Phone calls from criminals impersonating IRS agents remain an ongoing threat to taxpayers.
  3. Identity Theft: Taxpayers should be alert to tactics aimed at stealing their identities. The IRS continues to pursue criminals who file fraudulent tax returns using someone else’s Social Security number.
  4. Return Preparer Fraud: Most tax professionals provide honest, high-quality service. However, there are some dishonest preparers who scam clients. These preparers commit refund fraud, identity theft and other scams that hurt taxpayers.
  5. Fake Charities: Groups masquerading as charitable organizations solicit donations from unsuspecting contributors. People making donations should take a few extra minutes to make sure their money goes to legitimate charities.
  6. Inflated Refund Claims: Taxpayers should be wary of anyone promising inflated tax refunds. Some signs of this include preparers who ask clients to sign a blank return or those who promise a big refund before looking at taxpayer records.
  7. Excessive Claims for Business Credits: Taxpayers should avoid improperly claiming the fuel tax credit. Most taxpayers aren’t eligible for this credit, as the law usually limits it to off-highway business use, including farming.
  8. Falsely Padding Deductions on Returns: Taxpayers should avoid the temptation to falsely inflate deductions or expenses on their tax returns. Taxpayers do this to pay less than what they owe or receive a larger refund than they should get.
  9. Falsifying Income to Claim Credits: Con artists may convince taxpayers to invent income to erroneously qualify for tax credits, such as the Earned Income Tax Credit.
  10. Frivolous Tax Arguments: Some taxpayers use frivolous tax arguments to avoid paying tax. Promoters of these schemes encourage taxpayers to make outlandish claims about the legality of paying taxes. These claims are repeatedly thrown out in court.
  11. Abusive Tax Shelters: Taxpayers who use abusive tax structures do so to avoid paying taxes. The majority of taxpayers pay their fair share, and everyone should be on the lookout for people peddling tax shelters that sound too good to be true.
  12. Offshore Tax Avoidance: It’s a bad bet to hide money and income offshore. People involved in offshore tax avoidance are best served by voluntarily disclosing offshore money and getting caught up on their tax-filing responsibilities.

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(Monday, March 22, 2018) PA Workshop Ensures Best Practices in Coding Validation Reviews

PA Workshop Ensures Best Practices in Coding Validation Reviews

MedReview’s periodic Physician Advisor Workshops took place this quarter on January 10 and March 22, the first concerning pediatrics and the other, internal medicine, and both dedicated to MedReview’s unique healthcare audit service: code validation.

The company’s top physicians facilitated the meetings, which are intentional dialogues between department directors and doctors to ensure consistency in the validation process and its outcomes.  CMO and VP Seth Lewin, MD, and Senior Medical Director Edward L. Saxer, MD, led the internal medicine workshop; Medical Director of Pediatrics Richard J. Bonforte, MD, FAAP, led the other.

“We have these meetings to get everyone up to date and on the same page regarding the audit process and quality assurance issues. The managers of our review departments bring an expert coding perspective that complements the doctors’ review,” says Dr. Bonforte.

The goal, he explains, is to “ensure that the assigned insurance code for a patient’s care—which determines the cost of that care—matches the actual services, medication and procedures provided. For example, if there is a code indicating that hospital staff treated a patient for a flu and administered certain treatments and care, does the documentation in the hospital record validate that treatment and care?”

“We audit the patient’s medical chart,” he states. “We look at such questions and problems to get the doctors and coders on the same page.”

In total, twenty directors, reviewers and physicians participated in the workshops.

 

(Sunday, March 18, 2018) CEO Stamm Celebrates Community Activists & Politicians at COJO Legislative Breakfast

CEO Stamm Celebrates Community Activists & Politicians at COJO Legislative Breakfast

CEO Joseph Stamm joined 250 activists and leaders on March 18 at the 39th Annual Community Legislative Breakfast of the Council of Jewish Organizations of Flatbush. The event awarded nine individuals for leadership and excellence in public and legislative service, banking and commerce, medicine, volunteerism, philanthropy, and education. This year’s honorees were:  NYS Majority Leader John J. Flanagan; NYC Council Speaker Corey Johnson; Kings County DA Eric Gonzalez; NYS Assemblyman Walter T. Mosley; President and CEO of Maimonides Hospital Kenneth Gibbs; IBE Trade Corporation President Alex Rovt; Rabbi Yosef Eisen of Kollel Bnei Torah and Kehilah Kashrus; Capital One Bank Market Manager Connie Waterman; and COJO Volunteer Rachel Navifar.

“The COJO breakfast is a unique opportunity to mingle with government officials and business leaders and talk about what MedReview is doing to serve the healthcare industry and the public,” states CEO Stamm.

A non-sectarian, non-profit social services agency, COJO addresses an array of community concerns such as education, entitlements, employment, housing, and youth development through linkages with private and civic organizations. In the past year, COJO has provided over 25,000 clients with more than 58,000 services through its programs.

(Sunday, March 18, 2018) Political Roundup

On New Year’s Day, CEO Joe Stamm began his annual rounds of the political circuit at City Hall where he joined 900 fellow citizens who braved frigid cold temperatures to celebrate the second inaugurals of New York’s top three officials: Mayor Bill de Blasio, Comptroller Scott Stringer, and Public Advocate Letitia James.

Senator Bernie Sanders administered the mayor’s oath of office and praised de Blasio for making his city “one of the most progressive” in the nation. The Mayor spoke about his first-term accomplishments and his second-term aspirations, citing the city’s lowest murder rate since 1951 due to his neighborhood policing policies and pledging more affordable housing and good paying jobs for working people.

The Comptroller talked about the “62,000 New Yorkers sleeping in homeless shelter” and pledged to create “real, local wealth” in every neighborhood. “We cannot be a city where the entrance fee is a two-million-dollar condo,” he said. Public Advocate James focused on the need for police and community partnerships and public housing “free of dangerous lead.” “More homes” are the “best solution to homelessness,” she said. “All New Yorkers want a safe neighborhood where police and community are partners and where your success is determined by your hard work and God-given potential. These are not Republican or Democratic values. These are not even just New York values. These are American values.”

Afterwards, Mr. Stamm celebrated with each of the winners: James at Manhattan Proper; Stringer at Wooly Publixe; and de Blasio at the Tweed Courthouse.

Two days later, MedReview’s CEO and Director of Corporate Outreach Maurice Bortz went to Albany to hear Governor Andrew Cuomo deliver his final State of the State of his second term in office. He opened his speech with his bona fides as a leader of progressive government, invoking the names of two illustrious predecessors in this political stream: his father, Mario Cuomo, and President Franklin D. Roosevelt, who also once served as New York’s top official.

“Our economy is stronger today and we are once again the nation’s beacon for social progress,” Cuomo declared, citing achievements ranging from reduced crime, a cleaner environment and land conservation to “historic” investments and fiscal discipline….Every New Yorker’s tax rate is lower today than when I took office. We have the highest credit rating in 40 years, unemployment is down from 8.3 percent to 4.7 percent, and down in every single region of the state. Today New York State has 8.1 million private sector jobs—the highest number of jobs in history.”

Cuomo also called out the “unprecedented challenges ahead” due to Washington’s intention to dismantle hard-won victories against discrimination, sexism, terrorism, environmental threats, and opioid addiction, and to impose a tax on state and local income that would “threaten the essence of our economy.” His own economic and social development strategies for New York addressed women’s issues, health care and educational opportunities, criminal justice, homelessness, immigrant and worker rights, veterans, infrastructure, and environmental issues such as pollution, climate change as well as access to open space.

On February 13, CEO Stamm was at the Kings Theater in Brooklyn to hear Mayor Bill de Blasio deliver his first State of the City address of his second and final term in office. With a subtle twist on a recent presidential slogan, the Mayor promised to “make New York City the fairest big city in America.” Then citing his accomplishments to date including record low crime rates, pre-K access for every four year old and improved student test scores, de Blasio said, “We came into office determined to preserve the greatness of New York City…. We set audacious goals, and we have exceeded those goals.”

Finally, on March 18, CEO Stamm joined 250 activists and leaders at the 39th Annual Community Legislative Breakfast of the Council of Jewish Organizations of Flatbush to recognize nine outstanding local leaders:  NYS Majority Leader John J. Flanagan, NYC Council Speaker Corey Johnson, Kings County DA Eric Gonzalez, NYS Assemblyman Walter T. Mosley, Maimonides Hospital CEO Kenneth Gibbs, IBE Trade Corporation President Alex Rovt, Rabbi Yosef Eisen, Capital One Bank Market Manager Connie Waterman, and COJO Volunteer Rachel Navifar.