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.

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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.

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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.

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MedTrainer

APRIL 8, 2024

These requirements include but are not limited to: Health Insurance Portability and Accountability Act (HIPAA): Protects the privacy and security of patients’ health information. Medicare Access and CHIP Reauthorization Act (MACRA): Promotes value-based care and rewards healthcare providers for quality and performance.

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MedTrainer

JANUARY 31, 2024

Here are some key ways in which these programs have evolved: Increased Regulatory Complexity: As healthcare regulations have become more complex and numerous, compliance programs have had to keep pace.

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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. Designate a compliance officer and/or compliance committee.

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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).

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