MedTrainer

APRIL 8, 2024

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. What Is an Internal Healthcare Compliance Audit?

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MedTrainer

JANUARY 12, 2024

At its core, healthcare compliance ensures the quality of care, patient safety, and integrity of healthcare systems. Over the years, healthcare compliance has evolved significantly, driven by changing regulations, advances in technology, and a growing emphasis on patient-centric care. What is Healthcare Compliance?

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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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MedTrainer

MARCH 28, 2024

Healthcare compliance. Just as perplexing is who is responsible for compliance in healthcare organizations. The answer has as many layers as the definition of compliance itself. The answer has as many layers as the definition of compliance itself. Who in the Organization Is Responsible for Healthcare Compliance?

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Compliancy Group

JANUARY 3, 2024

This article discusses the issues related to medical billing compliance policy and the steps for providers to maintain financial integrity and adherence to all requirements. Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices.

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Compliance Now

DECEMBER 20, 2022

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting. The good faith transition relief that formerly shielded employers from penalties for incorrect and/or incomplete ACA filings is no longer available. Below is an overview of several items that plan sponsors should be mindful of this season.

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Compliance Now

DECEMBER 20, 2022

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting. The good faith transition relief that formerly shielded employers from penalties for incorrect and/or incomplete ACA filings is no longer available. Below is an overview of several items that plan sponsors should be mindful of this season.

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MedTrainer

JANUARY 31, 2024

Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program? It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. However, it wasn’t until the mid-20th century that healthcare compliance regulations and programs began.

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Medisys Compliance

NOVEMBER 6, 2023

Introduction Orthopedic billing compliance is essential for healthcare providers to avoid costly audits and penalties. By following a comprehensive orthopedic billing compliance checklist, providers can ensure that their claims are accurate, complete, and supported by proper documentation.

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Compliance Now

OCTOBER 10, 2023

By Megan Diehl, director of compliance consulting, MZQ Consulting The Internal Revenue Service (IRS) recently released draft instructions for preparing, distributing, and filing 2023 Forms 1094-B/C and 1095-B/C. This year, employers could mail their Forms 1094 and 1095 to the IRS if their submission included fewer than 250 forms.

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MedTrainer

AUGUST 31, 2023

Yet, navigating the intricacies of healthcare compliance can be daunting. It’s why we’ve compiled a series of the most common healthcare compliance FAQs and their answers. Any healthcare professional curious about compliance practices will find these answers helpful, insightful, and empowering. What Is Healthcare Compliance?

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Compliance Now

DECEMBER 22, 2022

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting. To comply with the ACA, non-grandfathered health plans cannot require a participant to pay more out-of-pocket during the plan year than the amounts listed below. Under the ACA, the OOP limitation requirement directly applies to essential health benefits.

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Compliance Now

DECEMBER 22, 2022

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting. To comply with the ACA, non-grandfathered health plans cannot require a participant to pay more out-of-pocket during the plan year than the amounts listed below. Under the ACA, the OOP limitation requirement directly applies to essential health benefits.

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Compliance Now

MARCH 8, 2022

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting. Under the ACA, non-grandfathered group health plans must provide benefits for “preventive care” on a first-dollar basis. This means such coverage must be provided at no cost to participants (i.e., no co-payments, co-insurance, or deductibles may be applied).

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Compliance Now

APRIL 6, 2022

On April 5, 2022, the Administration issued new proposed regulations changing certain aspects of the affordability and minimum value rules under the Affordable Care Act (“ACA”). Jennifer Berman, CEO, MZQ Consulting. However, since its inception, concerns have been raised about the “family glitch.”

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Compliance Now

JULY 14, 2023

By Jessica Waltman Late last week, the Departments of Health and Human Services, Labor, and Treasury (the Departments) published a set of FAQs that clarify how certain surprise billing protections interact with the Affordable Care Act’s (ACA) maximum out-of-pocket limit (OOP) requirements.

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Compliancy Group

FEBRUARY 12, 2024

Meeting Medical Billing Compliance Standards Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices. Compliancy Group’s healthcare compliance tracking software enables organizations to implement policies, procedures, and training to prevent fraud.

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Healthcare Law Blog

JANUARY 26, 2023

The ACA also allows states to prohibit abortion coverage in their qualified health plans, but requires that such plans provide notice to potential enrollees of the exclusion of abortion coverage. If non-compliance is found, OCR will inform the relevant parties and the matter will be resolved informally whenever possible.

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Medisys Compliance

APRIL 25, 2023

Need of Choosing Oncology Billing Company As an oncology practice, selecting the right billing company is a crucial decision that can significantly impact your financial success and regulatory compliance. On the other hand, a wrong choice can lead to delayed payments, billing mistakes, and even regulatory non-compliance issues.

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YouCompli

AUGUST 9, 2023

An opportunity to reframe, regroup, and refocus  Now that the COVID-19 Public Health Emergency (PHE) is well behind us, we have an opportunity to reframe patient expectations – and regroup and refocus on compliance-related patient care needs. You can use commercially available tools or create your own.

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MedTrainer

MAY 10, 2024

This process is vital for enhancing the accessibility and affordability of mental health services, aligning with the comprehensive healthcare coverage expansions under the Affordable Care Act ( ACA ).

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MedTrainer

JUNE 28, 2023

Benefits of the CFE in Healthcare Compliance Working with a CFE gives providers access to specialized skills, knowledge, and resources for effectively managing fraud risks. They can also help strengthen compliance programs and protect against financial losses due to fraudulent activities. Compliance Program Enhancement.

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Healthcare IT Today

OCTOBER 19, 2023

Compliance: Are service delivery systems and interpreters HIPAA compliant? Languages: Do you have reliable access to interpreters with rare language combinations and specialized skill sets? Reporting: Can you access and monitor usage of your language services?

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Compliance Now

JUNE 27, 2022

If such a plan only provided for travel benefits, it would raise its own set of compliance issues (e.g., failure to comply with the ACA, COBRA, HIPAA, etc.). Any employer program providing medical care is by definition a group health plan. Other Considerations.

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Compliance Now

JANUARY 20, 2022

The ACA requires non-grandfathered health plans to pay for “preventive care” on a first-dollar basis, meaning that no copays, coinsurance, or deductibles can be charged for certain services defined as “preventive” under these rules. By: Jessica Waltman, Principal, Forward Health Consulting.

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Medisys Compliance

JULY 27, 2022

Section 4104 of the Affordable Care Act (ACA) defined the term ‘preventive services’ to include ‘colorectal cancer screening tests’ and, as a result, it waives any coinsurance that would otherwise apply under Section 1833(a)(1) of the Social Security Act for screening colonoscopies. Background for Reduced Co-Insurance.

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Med-Net Compliance

NOVEMBER 8, 2022

The inspection objective was to determine whether the direct care licensed nursing hours recorded at the nursing home supported the hours submitted to the US Centers for Medicare & Medicaid Services (CMS) in compliance with federal requirements.

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Verisys

MARCH 24, 2022

We’ll explore what the OFAC Sanctions List means for healthcare organizations, how maintaining compliance with OFAC rules reduces reputational, financial, and patient risk, and the steps individual providers and entities can take to be removed from the OFAC list. businesses and individuals. However, the U.S.

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C&M Health Law

FEBRUARY 11, 2022

The Tri-agencies were critical of overall compliance—indeed, they found no comparative analyses to be initially compliant—but have not yet issued any final determinations of non-compliance, although some inquiries are ongoing. The 2022 annual report is only the beginning of the post-2021 CAA era.

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Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. United States Dep’t of Health & Hum. 20-50963, 2022 WL 807554, at *1 (5th Cir. The Risk-Adjustment Program.

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Bill of Health

APRIL 13, 2022

In addition to ensuring compliance with the timeline requirements for the unwinding period, this may empower policymakers to quantify the effects of continuous enrollment, as well as different approaches to renewals, to make long-term strategies for improving coverage.

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MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

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YouCompli

JANUARY 19, 2022

How are healthcare providers and compliance professionals balancing employee privacy with communications to colleagues and patients? It’s also a critical compliance issue. It’s important from a compliance perspective, and it’s also about empathy. This creates an especially sensitive situation when it comes to privacy.

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MedTrainer

JANUARY 26, 2024

What compliance regulation most directly affects the operations of a healthcare provider? HIPAA compliance is a fundamental aspect of healthcare operations in the United States, playing a pivotal role in safeguarding patient privacy and data security. Impacts every employee. Impacts technology used.

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MedTrainer

AUGUST 2, 2023

Auditing helps healthcare organizations maintain accurate and appropriate documentation, optimize revenue, minimize compliance risks, and improve overall operational efficiency. The Importance of Medical Auditing From a compliance standpoint, medical auditing serves several important purposes within healthcare organizations.

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C&M Health Law

NOVEMBER 23, 2020

The Departments’ estimates for the immediate regulatory compliance costs of the rule wildly outstrip the estimates for the rule’s potential savings. billion to $7.9 billion.

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Hall Render

SEPTEMBER 1, 2023

Louis hospital ‘You can’t do this to people’: Patients say they waited 12 hours to be treated at hospital Missouri health system names CEO Petitions seek to add rape, incest exceptions to Missouri abortion law Cigna exiting ACA exchanges in Kansas, Missouri for 2024 ‘It’s a win-win for everybody’: Gov.

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