MedTrainer

JANUARY 12, 2024

The protection of patient data, adherence to privacy regulations like the Health Insurance Portability and Accountability Act (HIPAA) in the United States, and the prevention of cyber threats have become paramount concerns. Compliance in healthcare began to encompass billing, fraud, and abuse prevention.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

MedTrainer

MARCH 28, 2024

Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations. This is one of seven components recommended in the OIG’s compliance guidelines. For all-size organizations, the owner(s)/executive team has a legal and ethical responsibility to maintain compliance.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

JUNE 28, 2023

CFEs collaborate with various stakeholders — including compliance officers, legal teams, auditors, and law enforcement agencies — to address fraud and compliance-related issues. The FCA prohibits submitting false or fraudulent claims for payment to government healthcare programs, such as Medicare and Medicaid.

Fraud 52

Fraud Compliance Governance Compliance Officers 52

MedTrainer

NOVEMBER 15, 2023

It conducts audits, investigations, and evaluations to ensure efficiency and integrity in HHS programs, including Medicare and Medicaid. The OIG also enforces standards for healthcare providers and suppliers to prevent fraud and imposes penalties for non-compliance.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

MedTrainer

AUGUST 2, 2023

They review healthcare claims and billing practices to ensure accuracy, detect fraud or abuse, and assess compliance with the payer’s policies and guidelines. Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS).

Compliance 52

Compliance ACA Medicaid Medicaid 52