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Compliance and Guidance Documents

Death Certificates

Effective January 1, 2011, the physician last in attendance upon the deceased must submit a death record using the online Indiana Death Registration System (IDRS). The death record must be completed within five (5) days of initiating the document process or receiving notification from the person in charge of interment. Fines of up to $1,000 can result from a failure to comply with this law beginning January 1, 2012.

In order to use the IDRS, physicians must first be registered. To register, complete a Confidentiality and User Agreement that can be found on the IDRS website. Registration can take several days to process, so it is prudent to register before you need to use the system, or you may not be able to comply with the 5-day death certificate filing timeline.

For more information, including training tutorials on how to use IDRS, visit the IDRS website here. A Tip Sheet is available on the ISMA website.

Breast Density Notification

Effective July 1, 2013, a facility that performs a mammography examination must identify patients who have “dense breasts” (defined as a patient with an amount of breast and connective tissue in comparison to fat in the breast that would require follow up care or testing) and notify the patient as such in the written mammography report. The law also requires the Medical Licensing Board of Indiana (MLB) to adopt rules or protocol on an education program to be used to educate women with high breast density and standards for providing an annual screening or diagnostic test for a woman who is at least forty (40) years old and who has high breast density. Those rules and protocols have not yet been adopted. Until then, the following resources are available through the American College of Radiology:

Click here to view the SEA 414.

Gifts from Industry

The Physician Payment Sunshine Act was included as Section 6002 of the Affordable Care Act of 2010. This Act requires applicable manufacturers to report certain industry gifts to the Department of Health and Human Services. Applicable manufacturers must also disclose any investment or ownership interests that a physician or physician's family member has in their company.

Once disclosed, this information will be made available on a public website and will be searchable by physician name, specialty, and address. Consumers will also be able to see what items were provided to physicians, as well as their value.

On December 19, 2011, CMS published a proposed rule for the Physician Payment Sunshine Act. The proposed rule is available here.  CMS is expected to publish the final rule by the end of 2012 and will not require data collection by applicable manufacturers before January 1, 2013. For more information on the Physician Payment Sunshine Act, visit The CMS Blog or see the following ISMA e-Reports articles:

Indiana law does not specifically address industry gifts to physicians, but the AMA has developed ethical policies on the topic. These policies are available on the AMA's website.

Indiana Unclaimed Property Act

The Indiana Unclaimed Property Act requires almost every business organization and governmental body to report and return property to the Indiana Attorney General's Unclaimed Property Division when the owner of that property cannot be found and the property has been unclaimed for a certain period of time (e.g., patient credit balances – 3 years; wages/payroll checks – 1 year).  “Property” can include patient credit balances as well as employee wages.  If a current patient has a credit balance, the law does not apply.

Ind. Code § 32-34-1-26 requires that due diligence be performed on all unclaimed property valuing $50 or more. Due diligence entails the following:

    • Examine records to find all unclaimed property.
    • Determine the owner of the property.
    • Use other internal resources to locate owners.
    • Verify that the owner has made no verbal or written contact with you concerning the property.
    • Attempt to contact the owners by first class mail at their last known address. This must be completed in no less than sixty (60) days, but no more than one hundred twenty (120) days, before filing a report.  A sample due diligence letter is available here.
    • Return money to owners you locate.
    • Register for online reporting here.
    • Report all unclaimed property to the state. The annual reporting deadline in Indiana is November 1.

If a business fails to comply with the Indiana Unclaimed Property Act, the business can be assessed interest and face other penalties.  Indiana's Unclaimed Property Act is available here.  For more information, visit IndianaUnclaimed.com and see the following ISMA e-Reports articles:

Discounts to Patients

This issue is not addressed by Indiana law. The Department of Health and Human Services Office of Inspector General issued a 6-page guidance document entitled, "Hospital Discounts Offered to Patients Who Cannot Afford to Pay their Hospital Bills" on February 2, 2004. The ISMA provided a summary of this guidance in its August 7, 2006 ISMA Reports issue. On June 18, 2007, the OIG issued an addendum to the original guidance document.

Impaired Drivers

Indiana law does not require physicians to report patients who may be medically or physically impaired. However, Indiana law does provide immunity for physicians who voluntarily report patients to the Bureau of Motor Vehicles who the physician in good faith believes are not fit to operate a motor vehicle safely so long as the physician has personally examined the patient within the thirty (30) days prior to making the report. IC 9-24-10-7.5.

The AMA has developed “The Older Drivers Project,” which includes education, patient counseling and ethical policies.

Disclosure of Financial Interest

Indiana law requires physicians to disclose ownership interests in facilities to which they are referring a patient and obtain a written statement from the patient that such disclosure was made. ISMA provided a summary of this law in its May 20, 2006 newsletter. The law is available at IC 25-22.5-11-1 et seq.

Compliance Program

The Health and Human Services Office of Inspector General published the “OIG Compliance Program for Individual and Small Group Physician Practices" on October 5, 2000.

 

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