Remove Blog Remove Compliance Remove Medicaid Remove Payment Systems
article thumbnail

The History of Healthcare Compliance

MedTrainer

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?

article thumbnail

Compliance Risks Associated with Outlier Payments 

YouCompli

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Price increases can sometimes result in inappropriate outlier payments. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. If they were not, the hospital must return the funds.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

CMS Imposes New Requirements on Payers to Improve Prior Authorization Process and Payer, Patient and Provider Communications

Hall Render

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

article thumbnail

2023 Deadline for Physicians, Advanced Practice Providers and Teaching Hospitals to Review Sunshine Act Data Approaching

Hall Render

Following this reporting, impacted providers and teaching hospitals will have until May 15, 2023, to review reported payments and investments and to dispute any incorrect reports. During the Dispute Period, Covered Recipients may use CMS’ Open Payments system to formally dispute any information they believe is incorrect.

article thumbnail

CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes

Healthcare Law Blog

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

article thumbnail

Nursing Home Update: CMS Unwinds Vaccine Mandate and More Regulations as Public Health Emergency End Nears

Hall Render

CMS expects all providers to be in compliance with the requirements for PASARR with all admissions taking place after May 11, 2023. Hall Render blog posts and articles are intended for informational purposes only. The F-Tag associated with this regulation is F-884. The CMS Memo confirmed that this waiver will end at the end of the PHE.

article thumbnail

CMS Corrects Inadvertent Omissions in Recent Stark Law Regulatory Amendments, Clarifies Reach of the Prohibition Related to Indirect Compensation Arrangements

Health Care Law Brief

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released its final rules for the 2022 Medicare Physician Fee Schedule (PFS Final Rule) and 2022 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS Final Rule). at 1396b(s).