MedTrainer

JANUARY 12, 2024

Healthcare compliance is serious business for regulators. In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. What is Healthcare Compliance?

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MedTrainer

FEBRUARY 12, 2024

government collected $2.2B How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims? How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims?

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MedTrainer

JANUARY 31, 2024

For the organization itself, compliance programs are the guardians that can help potentially prevent medical errors and regulatory violations, and mitigate other compliance risks. So, how do compliance programs protect healthcare? What is Healthcare Compliance?

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MedTrainer

FEBRUARY 12, 2024

Failing to report healthcare non-compliance is a lot like failing to tell your parents you got sent to the principal’s office. In this blog, we’ll outline why reporting healthcare non-compliance is non-negotiable and how software platforms make it easier to stay in compliance with the myriad regulations that govern good healthcare.

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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 26, 2024

Many individuals and organizations opt to obtain a healthcare regulatory compliance certificate to highlight that commitment. In this blog, we will explore what is a healthcare regulatory compliance certificates, provide a high-level description of its purpose, and list who typically uses such certificates.

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MedTrainer

OCTOBER 23, 2023

In today’s intricate healthcare landscape, compliance can mean a lot of different things, which might leave you wondering, “What is healthcare compliance?” At its core, healthcare compliance is adherence to the vast array of regulatory and procedural standards that protect patients and ensure the highest standard of care.

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MedTrainer

JANUARY 26, 2024

Non-compliance in healthcare refers to the failure of healthcare providers, institutions, or individuals to adhere to the laws, regulations, and standards established to protect patient welfare, maintain data security, and ensure the efficient and ethical delivery of healthcare services. What is Healthcare Compliance?

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Verisys

MARCH 23, 2023

3 Healthcare Fraud and Abuse Laws Providers Should Know About In 2021, the Department of Justice reported recovering over $5.5 billion from settlements due to fraud and false claims. Abuse of government healthcare programs is a federal offense with severe penalties. government or a government contractor.

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MedTrainer

NOVEMBER 6, 2023

When it comes to healthcare, compliance is not just a buzzword — it’s critical to ensuring quality of care, protecting patient privacy, and staying on the right side of the law. But what exactly is a compliance plan in healthcare, and why is it so crucial? Why Is a Compliance Plan Important in Healthcare?

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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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MedTrainer

JANUARY 26, 2024

The best way to maintain these standards is by providing healthcare compliance training for all staff members. Even when training is not required, it may still be very beneficial for your staff and overall organizational compliance. What topics should be covered in healthcare compliance training?

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Healthcare Compliance Blog

APRIL 29, 2022

in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. In March 2020 she pleaded guilty to one count of healthcare fraud, one count of wire fraud, and one count of theft of government funds. She used the money instead for her own personal gain. US Attorney Ashley C.

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MedTrainer

OCTOBER 4, 2023

To ensure organizations meet these standards, federal healthcare compliance requirements have been put in place. These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. What Are Federal Healthcare Compliance Requirements?

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MedTrainer

JANUARY 26, 2024

That means there’s a direct relationship between compliance and a healthcare organization’s revenue. To answer the question “how does compliance have an impact on financial management in healthcare,” we first need to explore the connections between the two. What is Healthcare Compliance?

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Verisys

JANUARY 8, 2024

A healthcare compliance audit is a thorough review and examination of an organization’s adherence to regulatory guidelines. This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations.

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Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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MedTrainer

NOVEMBER 14, 2023

Becoming certified in healthcare compliance is not just some letters after your name; it validates your expertise and dedication to upholding the laws, regulations, and ethical standards that govern healthcare practices. Use this checklist to shine bright in your compliance role.

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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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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. According to Grimm, the risk of alleged fraud and abuse in Medicare Advantage by plans, vendors, and providers is not to be ignored.

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YouCompli

DECEMBER 11, 2023

The long-awaited, new OIG General Compliance Program Guidance (GCPG) has been released, all 91 pages of it. If you have not viewed it yet, click here: [link] This release is the first major compliance guidance document the OIG has shared in many years. The compliance officer should either report directly to the CEO or the Board.

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Healthcare Compliance Blog

FEBRUARY 22, 2022

Two women, one from Colorado and the other from Houston, have been sentenced in federal court for their roles a multi-million dollar Medicare Fraud Scheme. Each woman pled guilty to one count of conspiracy to commit healthcare fraud. The post Two Women Sentenced for Conspiracy to Commit Healthcare Fraud appeared first on.

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Hall Render

NOVEMBER 10, 2023

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. Key Highlights of the GCPG Much of what is covered in the GCPG is not new to the health care compliance industry.

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MedTrainer

OCTOBER 16, 2023

This is the essence of corporate compliance in healthcare. Just as every piece of the puzzle must fit perfectly, every compliance element in healthcare needs precise integration to ensure seamless, ethical, and effective operations. Dive with us as we explore the complexities and necessities of compliance in the healthcare sector.

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MedTrainer

NOVEMBER 2, 2023

This critical responsibility rests on the shoulders of the healthcare compliance officer. Read on if you’ve ever wondered about the unsung heroes as we answer the question: What does a compliance officer do in healthcare? What Is the Primary Role of a Compliance Officer in Healthcare?

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Hall Render

APRIL 29, 2024

The disclosure must be made to the Criminal Division of the DOJ and must occur before any other corresponding government investigation or civil enforcement in order to be truly voluntary. Practical Takeaways Health care fraud is specifically listed as a key enforcement area for the DOJ.

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MedTrainer

AUGUST 28, 2023

Compliance with regulatory requirements is not just a necessity for healthcare providers; it’s a critical component of providing safe and ethical care to patients. What Is Healthcare Compliance Software? Here’s how: HIPAA compliance: Ensuring the privacy and security of patient information is a top priority.

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Verisys

FEBRUARY 14, 2024

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is healthcare data governance? What is GRC in Healthcare?

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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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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. New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. For a second violation, OMIG may increase the penalty to $10,000 per month.

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MedTrainer

FEBRUARY 5, 2024

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. So, what is the difference between provider enrollment and credentialing?

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Provider Trust

MARCH 13, 2023

Twenty-five people were charged with criminal wire fraud and wire fraud conspiracy for their involvement in the scheme, and these people could face up to 20 years in jail. Donna Thiel, Chief Compliance Officer at ProviderTrust, said, “It’s an opportunity to promote partnership between HR and compliance.

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MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital.

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AIHC

JUNE 6, 2023

AI Use in Healthcare Research & Quality As posted in the American Institute of Healthcare Compliance (AIHC) June monthly newsletter, the Agency for Healthcare Research & Quality (AHRQ) grantee is testing AI for use to improve breast cancer screening accuracy and efficiency. Beware of new companies offering such services.

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Verisys

FEBRUARY 9, 2024

January 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

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Provider Trust

MAY 17, 2022

So what does that mean for your healthcare organization’s compliance program? Is your organization properly vetting and monitoring compliance of your entire vendor network? Which regulations govern vendor compliance? Vendor Z provides contract janitorial services.

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Verisys

JULY 27, 2023

Achieving Transparency: How to Close A Critical Gap in Healthcare Compliance Continuous Data Monitoring is Key to Patient Safety Employing quality providers results in better patient outcomes. That is, until there is a fine, civil monetary penalty, or public lawsuit caused by patient negligence or fraud.

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