Provider Trust

JULY 17, 2023

In our recent webinar, ProviderTrust’s Chief Compliance Officer, Donna Thiel, shared her expertise and valuable feedback from the 2023 HCCA Compliance Institute. Watch the Webinar During the Keynote Speech at the HCCA Compliance Institute this year, Office of Inspector General (OIG) Christi A.

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The Health Law Firm Blog

JANUARY 4, 2024

On November 6, 2023, the U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG), released 91 pages of "General Compliance Program Guidance" (GCPG) on its website. This is the first compliance program guidance the OIG has released since 2008. The GCPG provides general compliance guidance, [.]

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Medisys Compliance

JANUARY 30, 2023

Let us discuss the top compliance issues in the medical billing industry, shall we? Medical billing companies and healthcare providers that participate in these programs must comply with a variety of regulations, including billing and coding guidelines, documentation requirements, and fraud and abuse laws.

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Health Law RX

JANUARY 30, 2024

By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The DOJ Announcement stresses the importance of investing in strong compliance programs for both the buyers and sellers in business transactions.

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American Medical Compliance

MAY 22, 2023

million to settle allegations that it paid kickbacks to healthcare providers committing fraud violations. US Efforts to Crack Down on Fraud Violations Kickbacks are illegal under the False Claims Act because they can lead to overuse or misuse of medical products, harming patients and increasing healthcare costs. DePuy Synthes, Inc.

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MedTrainer

FEBRUARY 12, 2024

How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims? In this blog, we’ll share how healthcare organizations are managing compliance around false claims and safeguarding both the integrity of healthcare services and the welfare of patients.

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Healthcare Blog

NOVEMBER 9, 2023

An effective healthcare compliance program is a crucial aspect of any healthcare organization. Healthcare organizations should clearly define their expectations and the consequences for non-compliance. Healthcare organizations should clearly define their expectations and the consequences for non-compliance.

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American Medical Compliance

FEBRUARY 15, 2023

The Dental Healthcare Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. To become certified, please visit us at: American Medical Compliance (AMC).

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Med-Net Compliance

OCTOBER 27, 2022

The psychologist was convicted of four counts of healthcare fraud. He is scheduled to be sentenced on April 18, 2023, and faces a maximum penalty of 10 years in prison on each count. Train staff upon hire and at least annually on your compliance and ethics policies and procedures and on what can be considered a false claim.

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Health Care Performance

APRIL 19, 2023

Department of Justice, Criminal Division, publishes a guidance document: Evaluation of Corporate Compliance Programs (ECCP). The DOJ has updated the guidance multiple times, most recently in March 2023. The DOJ guidance focuses on three questions: Is the corporation’s compliance program well designed?

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The Health Law Firm

DECEMBER 4, 2023

On November 6, 2023, the US Department of Health and Human Services (HHS), Office of the Inspector General (OIG), released 91 pages of "General Compliance Program Guidance" (GCPG) on its website. This is the first compliance program guidance the OIG has released since 2008. Missigman, J.D.

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Compliancy Group

FEBRUARY 26, 2024

In the evolving healthcare industry, adhering to compliance rules and standards while staying on top of regulatory changes is paramount. A comprehensive hospital compliance work plan is pivotal for achieving these objectives. What Are Hospital Compliance Work Plans?

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American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Fraud schemes range from solo ventures to widespread activities of an institution or group.

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Provider Trust

MARCH 21, 2023

Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs. As Medicare Advantage continues to grow, the risk of provider-level fraud will also increase.

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Health Law RX

NOVEMBER 22, 2023

Department of Health and Human Services (the OIG) recently released an updated General Compliance Program Guidance document (GCPG). The GCPG discusses general compliance risks and compliance considerations. The GCPG discusses general compliance risks and compliance considerations. Other Compliance Considerations.

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Innovaare Compliance

OCTOBER 6, 2022

And, in 2023, there will be more enrollees in MAPD than in original Medicare. Medicare Advantage Organizations (MAO) not only have to get ready for newcomers, they also have to implement changes in the MA program that are not waiting to become effective on January 1, 2023; some are happening or have already begun!

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HIT Consultant

JANUARY 3, 2023

But they have also expanded the attack surface at these organizations and increased the level of risk and vulnerabilities that could result in direct loss of proprietary information, direct financial damage including theft and fraud, and potential loss of life (in addition to regulatory fines and brand damage) the healthcare sector faces.

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Healthcare Law Blog

MAY 11, 2023

The Department of Health and Human Services Office of Inspector General (OIG) recently announced changes to its process for informing healthcare industry stakeholders of new or updated Compliance Program Guidance (CPG). When to Expect New CPG The OIG expects to issue updated GCPG by the end of calendar year 2023.

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Provider Trust

AUGUST 9, 2023

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released its latest 2023 Spring Semiannual Report to Congress, providing a comprehensive overview of its activities from October 2022 to March 2023. Led by acting Inspector General Christi A. What is the HHS-OIG Semiannual Report to Congress?

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AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

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Healthcare IT Today

JANUARY 2, 2023

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. We are going to see an increased demand for privacy-preserving technology in 2023, and therefore more investment in the space. during 2023. Check out our community’s healthcare Security and Risk predictions.

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Med-Net Compliance

SEPTEMBER 20, 2022

The defendant was also convicted for falsification of records designed to prevent detection of this fraud and aggravated identity theft for falsely corresponding with Medicare under the name of another physician. Million Healthcare Fraud Scheme appeared first on Med-Net. He is scheduled to be sentenced on Jan.

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YouCompli

JANUARY 18, 2023

Featured speakers : Eric Gold , Chief, Massachusetts Attorney General’s Office Healthcare Division; Jennifer Goldstein , Managing Attorney, Medicaid Fraud Division, Massachusetts Attorney General’s Office; and Steven Sharobem , Assistant US Attorney, District of Massachusetts. Priorities for Massachusetts’s Medicaid Fraud Division.

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HIPAA Journal

OCTOBER 21, 2022

A pharmaceutical sales rep has pleaded guilty to conspiring to commit healthcare fraud and wrongfully disclosing and obtaining patients’ protected health information in an elaborate healthcare fraud scheme involving criminal HIPAA violations. Alario pleaded guilty to his role in the healthcare fraud scheme earlier this month.

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Provider Trust

MARCH 13, 2023

On January 25, 2023, the US Department of Justice joined with the Federal Bureau of Investigation (FBI) and the US Department of Health and Human Services Office of Inspector General (HHS-OIG) to launch a multi-state law enforcement action to apprehend individuals involved in this fraudulent nursing degree scheme. Are you in Florida?

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Hall Render

NOVEMBER 10, 2023

On November 6, 2023, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) issued new General Compliance Program Guidance (“GCPG”) for members of the health care compliance community and other health care stakeholders.

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Total HIPAA

MARCH 22, 2023

In this blog post, we’ll discuss the potential consequences of HIPAA non-compliance for insurance agents. The most significant consequence of HIPAA non-compliance is the potential for legal action. In addition to financial penalties, HIPAA non-compliance can damage an insurance agent’s reputation and lead to a loss of clients.

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Total Medical Compliance Resources

OCTOBER 10, 2023

One of the critical aspects of achieving HIPAA compliance is enforcing a mandatory password policy. Once inside, hackers can steal personal health information (PHI), leading to data breaches that tarnish the reputation of the healthcare provider and put patients at risk of identity theft and medical fraud.

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HIPAA Journal

APRIL 25, 2024

City of Hope National Medical Center identified suspicious activity within its network on October 13, 2023, and the forensic investigation confirmed there had been unauthorized access by a third party between September 19, 2023, and October 12, 2023.

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Healthcare Law Blog

FEBRUARY 3, 2023

New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1]

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HIT Consultant

JUNE 21, 2023

The success of the project has led the company to invest in further enhancing the new mobile solution to take payment at the point of delivery from October 2023. One of Apria’s priorities for the project was an easy installation, which is why they chose Pega’s low code, off-the-shelf solution to integrate into their existing system.

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Health Law Advisor

AUGUST 25, 2023

It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. These regulations were proposed to implement portions of the New York State 2020-2021 Budget Bill amending the mandatory compliance program requirements. New York Social Services Law § 363-d.

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Verisys

MAY 3, 2023

7 Core Elements of Healthcare Compliance Plan and How to Measure Them Healthcare compliance regulations are complex and ever-changing, but are an essential part of any healthcare organization’s effort to provide safe, high-quality care for patients. What is an effective healthcare compliance program?

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Innovaare Compliance

JUNE 8, 2023

These changes, which went into effect on January 1, 2023, are designed to ensure health plans are accurately reporting their costs and that they are not overcharging the government. Review your financial arrangements: Make sure that your financial arrangements with providers are in compliance with CMS regulations.

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C&M Health Law

DECEMBER 18, 2023

Department of Health and Human Services (HHS) published the General Compliance Program Guidance (GCPG) on November 6, 2023. The GCPG provides updated descriptions of the seven elements of an effective compliance program that health care entities have long relied upon. The Office of the Inspector General (OIG) of the U.S.

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Innovaare Compliance

MARCH 24, 2024

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.

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AIHC

JUNE 6, 2023

OpenAI’s ChatGPT 2023 & the National Institutes of Health AI is developing at lightning speed. The government’s National Institutes of Health (NIH) published an article in February 2023 entitled “ Opportunities and risks of ChatGPT in medicine, science, and academic publishing: a modern Promethean dilemma. ”

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