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Answers to the Most Common Compliance FAQs

MedTrainer

Let’s delve into the world of compliance with answers to the most common compliance FAQs. What Is Healthcare Compliance? Healthcare compliance refers to the process of adhering to the laws, regulations, and ethical standards that govern the healthcare industry. What Are the Consequences of Non-Compliance?

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The History of Healthcare Compliance

MedTrainer

So, how has the history of healthcare compliance changed since its inception? What is Healthcare Compliance? Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Compliance in healthcare began to encompass billing, fraud, and abuse prevention.

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Who Started the First Healthcare Compliance Program?

MedTrainer

Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program? federal government enacted the Federal False Claims Act (FCA) in 1863 during the American Civil War. It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations.

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What is a Certified Fraud Examiner (CFE)?

MedTrainer

The primary goal of a Certified Fraud Examiner in healthcare is to safeguard the integrity of healthcare systems and protect patients, insurance providers, and government programs from financial losses due to fraudulent activities. Typically, that means looking at the five main Federal laws governing healthcare fraud : False Claims Act (FCA).

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The Importance of Internal Healthcare Compliance Audits

MedTrainer

As a healthcare professional, it is vital to maintain compliance with the 629 legal and regulatory requirements that govern the delivery of quality care. One effective tool to achieve this is through internal healthcare compliance audits.

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Who Is Responsible For Compliance In Healthcare?

MedTrainer

This is one of seven components recommended in the OIG’s compliance guidelines. In large healthcare organizations, a compliance officer is typically responsible, however, in smaller organizations, such as physician practices, a case could be made for the entity’s compliance contact to be in one of several different roles.

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HIPAA: Healthcare’s Most Impactful Regulation

MedTrainer

At the top of the list is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA compliance is a fundamental aspect of healthcare operations in the United States, playing a pivotal role in safeguarding patient privacy and data security. What is HIPAA? Impacts every employee. Impacts technology used.

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