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?

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

Verisys

MARCH 1, 2024

As the healthcare industry is increasingly targeted for data theft and fraud, information security has emerged as a top priority for healthcare institutions. Governance, risk management, and compliance programs can all be automated, providing significant benefits to healthcare organizations.

Governance 52

Governance Compliance Fraud HIPAA 52

Verisys

MAY 13, 2024

April 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network.

Fraud 52

Fraud COVID-19 Doctors Licensing 52

Provider Trust

APRIL 26, 2023

Compliance and HR managers responsible for staffing should stay apprised of events that may have repercussions within the healthcare space. However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. This can spell trouble for everyone involved.

Licensing 52

Licensing Nurses Compliance COVID-19 52

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?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Provider Trust

JUNE 1, 2022

Organizations across the healthcare continuum have experienced several workforce trends that are creating gaps in license monitoring and verifications. In this post, we’ll explore three current challenges impacting the healthcare license and credential verification process.

Licensing 52

Licensing Nurses COVID-19 Compliance 52

Provider Trust

MARCH 13, 2023

State licensing boards nationwide have annulled the licenses of dozens of nurses who obtained fake degrees and used them to gain or secure employment. In Delaware, 26 nursing licenses were revoked when the nurses’ credentials were tied to the scheme. Are you in Florida? What are your pre-hire practices?

Fraud 52

Fraud US Department of Health and Human Services Licensing Compliance Officers 52

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?

Compliance 52

Compliance Fraud HIPAA Governance 52

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?

Compliance 52

Compliance Compliance Officers HIPAA Fraud 52

Verisys

APRIL 2, 2024

March 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 Physician pays $1.8M Million Medicare Fraud Scheme ( Full Story ) New York-Presbyterian/Brooklyn Methodist Hospital Settles Health Care Fraud Claims for $17.3

Fraud 52

Fraud Telemedicine Licensing Doctors 52

Verisys

JUNE 8, 2023

Data Compliance: How to Identify and Close Data Risk Gaps Using Technology A three-part compliance series that focuses on using technology to help you achieve your compliance goals. Hiring a provider with red flags, even if in the past, can put your organization at risk for non-compliance.

Compliance 52

Compliance Fraud Licensing Medicare 52

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.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Medicaid 52

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. The safety of your patients depends on making sound hiring decisions and ensuring that the licenses of your staff are current.

Compliance 52

Compliance Due Diligence Licensing Fraud 52

Verisys

MARCH 8, 2024

February 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Million Medicare and Medicaid Fraud Full Story Pharmacist Fraud Pharmacy Owner and Operations Manager Convicted of $2.3M Peters Physician Pleads Guilty to False Statements, Resulting in $1.4

Fraud 52

Fraud Medicaid Medicaid Medicare 52

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.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

Verisys

JULY 5, 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. The safety of your patients depends on making sound hiring decisions and ensuring that the licenses of your staff are current.

Compliance 52

Compliance Due Diligence Licensing Fraud 52

YouCompli

DECEMBER 19, 2023

Last month, the Office of Inspector General (OIG) published a new, user-friendly, 91-page General Compliance Program Guidance (GCPG). HIPAA Privacy and Security Rules (page 30): In bold print, the OIG recommends that compliance with Privacy, Security and Breach Notification Rule requirements be included in ALL risk assessments.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

Provider Trust

JULY 17, 2023

In our recent webinar, ProviderTrust’s Chief Compliance Officer, Donna Thiel, shared her expertise and valuable feedback from the 2023 HCCA Compliance Institute. Watch the Webinar During the Keynote Speech at the HCCA Compliance Institute this year, Office of Inspector General (OIG) Christi A.

Compliance 52

Compliance Nursing Homes Nurses Fraud 52

YouCompli

NOVEMBER 29, 2023

“As previous OIG compliance guidance(s) are retired to ‘archival’ status, we all should recognize that the original guidance may have been the most important document ever written for healthcare compliance professionals.” — Roy Snell In 1998, the Office of Inspector General (OIG) issued its first General Compliance Program Guidance (GCPG).

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

Verisys

JANUARY 2, 2024

Each month we will give a roundup of recent healthcare fraudsters and compliance busters. With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Secure your success by choosing Verisys.

Fraud 52

Fraud Licensing Doctors Medicare 52

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

Fraud 52

Fraud Medicaid Medicaid Medicare 52

MedTrainer

FEBRUARY 5, 2024

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. So, what is the difference between provider enrollment and credentialing?

Licensing 52

Licensing Governance Compliance Fraud 52

Provider Trust

JANUARY 26, 2022

It’s no secret–when fraud enters healthcare, things get risky. But how exactly does the HHS-OIG (Office of Inspector General), the main body responsible for conducting investigations into suspected fraudulent activity, address healthcare fraud and assess future risk of these bad actors?

Fraud 52

Fraud US Department of Health and Human Services Medicaid Medicaid 52

Provider Trust

JANUARY 18, 2023

In October 2022, the South Carolina Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old South Carolina woman named Alyssa Beth Steele for working as a registered nurse despite not having a license. Pursuant to federal regulations, the SCMFCU is authorized to investigate and prosecute any acts of Medicaid provider fraud.

Nurses 52

Nurses Licensing Fraud Medicaid 52

AIHC

JUNE 6, 2023

Algorithms perform relatively well on knowledge-based tests despite the lack of domain-specific training; ChatGPT achieved ~ 66% and ~ 72% on Basic Life Support and Advanced Cardiovascular Life Support tests, respectively, and performed at or near the passing threshold on the United States Medical Licensing Exam.

Compliance 59

Compliance Medical Billing HIPAA Due Diligence 59

Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.

Licensing 52

Licensing Fraud Compliance Nurses 52

AIHC

JUNE 6, 2023

Algorithms perform relatively well on knowledge-based tests despite the lack of domain-specific training; ChatGPT achieved ~ 66% and ~ 72% on Basic Life Support and Advanced Cardiovascular Life Support tests, respectively, and performed at or near the passing threshold on the United States Medical Licensing Exam.

Compliance 52

Compliance Medical Billing HIPAA Due Diligence 52

YouCompli

AUGUST 29, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. As FWA continues to emerge, and poses more of a risk to organizational compliance, professionals should become familiar with some of the potential areas of noncompliance associated with telehealth.

Fraud 52

Fraud Medicare Medicare COVID-19 52

Verisys

MARCH 1, 2024

Verisys stands at the forefront of enhancing Human Capital Management (HCM) within the healthcare sector by offering a suite of advanced compliance and data management solutions. Verisys plays a pivotal role in Human Capital Management (HCM) in healthcare through its advanced compliance and data management solutions.

Compliance 52

Compliance Fraud Licensing Governance 52

Provider Trust

AUGUST 16, 2023

Despite such mandates, OIG investigations over the past five years have found that vendors are accountable for much of the healthcare ecosystem’s fraud, waste, and abuse. Over the past several years, OIG has discovered that a significant amount of fraud, waste, and abuse occurs within the vendor domain.

Fraud 52

Fraud Compliance Licensing Compliance Officers 52

Provider Trust

MAY 18, 2022

What the HHS-OIG says about vendor compliance. However, healthcare receives federal funding, and thus OFAC is an additional sanction list that you should add to your vendor compliance plan/program. Case Study: S. Bay Mental Health Centers (and the associated PE firm) U.S. Martino-Fleming v. Get Daily Vendor Monitoring.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

YouCompli

JULY 26, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. As FWA in telehealth continues to emerge, and poses more of a risk to organizational compliance, professionals should become more familiar with it – and then work to curb it.

Fraud 52

Fraud Compliance Medicare Medicare 52

Verisys

FEBRUARY 16, 2023

Transition Process Oregon: License Suspensions and Terminations of Orders by Operation of Law and Continuing Education Deficiencies: Oregon Administrative Rule 847-001-0035 has been amended to expand the reasons for which the Executive Director or Medical Director may issue final orders.

Licensing 52

Licensing Nurses Fraud Compliance 52

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. Can I minimize risk of non-compliance with laws & regulations in healthcare?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Provider Trust

JULY 8, 2022

A holistic approach to exclusion monitoring and license verifications must include monitoring of disciplinary databases such as the National Practitioner Data Bank (NPDB). Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S. Who Can Search the NPDB?

Licensing 52

Licensing Malpractice Fraud Compliance 52

Verisys

NOVEMBER 30, 2022

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. Excluded from one means excluded from all, and the fines for non-compliance will likely be in the hundreds of thousands. License Verification & Monitoring. Credentialing.

Regulatory Compliance 52

Regulatory Compliance Medicare Medicare Medicaid 52

MedTrainer

APRIL 17, 2024

Navigating the complex landscape of state licensing laws can be time-consuming and costly for organizations. Security and Compliance: Telehealth providers must adhere to strict security and compliance standards to protect patient privacy and ensure the confidentiality of medical information transmitted electronically.

Licensing 52

Licensing Compliance Fraud HIPAA 52