MRO Compliance

APRIL 11, 2024

That’s why providers need to understand which path is best for them when it comes to partnering with an eCQM / Medicare CQM for direct Electronic Health Record (EHR) connection or using QRDA-1 for data uploads. This limitation poses risks to the reliability of quality reporting outcomes.

Regulatory Compliance 141

Regulatory Compliance Medicare Medicare Compliance 141

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?

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

MedTrainer

APRIL 20, 2023

That’s where compliance checklists come in. These helpful tools streamline your compliance systems and make it easier to ensure that your organization operates within the regulatory framework of your industry and specialty. Providers need a strong compliance program to inform the creation of compliance checklists.

Compliance 52

Compliance Compliance Officers Regulatory Compliance Regulations Compliance 52

Healthcare Blog

AUGUST 23, 2023

It is critical for an organization to have strategies for promoting ethical behavior in healthcare compliance. Strategies Healthcare Organizations Can Use to Promote Ethical Behavior in Compliance Ensuring ethical practices in healthcare compliance is essential to corporate health and the integrity of your organization.

Compliance 56

Compliance Nurses Regulatory Compliance Medicaid 56

Compliancy Group

JANUARY 17, 2024

The OIG Work Plan, sometimes referred to as “the Work Plan” or “the Plan,” is an essential tool in securing and maintaining healthcare regulatory compliance for patient safety, privacy, and quality care. The OIG Compliance Work Plan identifies significant risks and areas that require attention within the healthcare system.

US Department of Health and Human Services 52

US Department of Health and Human Services Compliance Regulatory Compliance Regulations Compliance 52

Healthcare Blog

APRIL 13, 2023

As hospitals have become increasingly complex organizations, effective governance, risk, and compliance (GRC) strategies have become essential for ensuring patient safety and regulatory compliance. What are the Key Components of a Successful Governance, Risk, and Compliance (GRC) Strategy? Stay Alert !

Governance 40

Governance Compliance Hospitals Regulatory Compliance 40

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 compliance? What is GRC in Healthcare?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Healthcare IT Today

DECEMBER 17, 2023

News In a blog post, ONC highlighted trends in patient access to electronic health information. Partnerships Darena Solutions, Leidos, and SLI Compliance unveiled a verification process for AI applications built using SMART on FHIR standards. Missouri-based Phelps Health chose KeyCare to support virtual care delivery through MyChart.

Hospitals 98

Hospitals Nurses Compliance Regulatory Compliance 98

Verisys

NOVEMBER 30, 2022

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. organizations that receive any funds from Medicare, Medicaid, TRICARE, or other federal programs cannot afford to employ individuals or entities excluded from even one program. Medicare opt out.

Regulatory Compliance 52

Regulatory Compliance Medicare Medicare Medicaid 52

Innovaare Compliance

NOVEMBER 29, 2023

On October 13, 2023, the Centers for Medicare & Medicaid Services (CMS) published the Readiness List for CY 2024. This has been a very useful tool for Medicare Advantage Organizations (MAO) to check their readiness to fulfill requirements in the new contract year.

Medicare 52

Medicare Medicare Compliance Medicaid 52

MedTrainer

JULY 12, 2023

Here’s a closer look at the critical role incident management software plays in risk mitigation and compliance in healthcare environments. Read this case study to discover how one organization’s use of online incident reporting, amongst other digital compliance tools, helped to add 50 additional practice locations. Risk Mitigation.

Compliance 52

Compliance Regulatory Compliance FDA Medicaid 52

MedTrainer

JULY 12, 2023

Here’s a closer look at the critical role incident management software plays in risk mitigation and compliance in healthcare environments. Read this case study to discover how one organization’s use of online incident reporting, amongst other digital compliance tools, helped to add 50 additional practice locations. Risk Mitigation.

Compliance 52

Compliance Regulatory Compliance FDA Medicaid 52

Med Com Blog

DECEMBER 14, 2021

AUSTIN, Texas – December 14, 2021 – Med Claims Compliance Corporation (MCC), a healthcare platform as a service (PaaS) company, today announced that MCC completed a $5.7 From the payor’s perspective, every year, the Medicare Fee- for-Service program improperly pays $25B+ due to insufficient and/or incomplete documentation.

Compliance 40

Compliance Regulatory Compliance Medicare Medicare 40

Innovaare Compliance

FEBRUARY 14, 2022

Healthcare organizations establish Compliance Departments with the primary purpose of providing compliance oversight for the organization. Operational teams—such as the Member Services Department and the Appeals & Grievances Department—have significant compliance regulations, so they must know to maintain compliance.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

AIHC

NOVEMBER 3, 2023

Read more about current regulatory oversight on the AIHC blog: Who Regulates Healthcare AI? Artificial Intelligence & Regulatory Compliance About the author Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS.

Department of Veterans Affairs 59

Department of Veterans Affairs Hospitals Compliance Nurses 59

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.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

Health Care Law Brief

NOVEMBER 17, 2021

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). Both rules take effect January 1, 2022.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

MedTrainer

AUGUST 30, 2023

Let’s explore what it means for an MCO to coordinate care for members, and the compliance implications that come with this healthcare services model. Medicare Advantage (Part C). Medicare Advantage plans are managed care plans offered by private insurance companies as an alternative to traditional Medicare (Parts A and B).

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

MedTrainer

OCTOBER 5, 2023

As a key member of your facility’s healthcare compliance programming, you understand the significance of regulatory compliance and the critical role it plays in ensuring the privacy and security of patient information. Your organization’s ability to practice regulatory compliance is only as good as what’s been documented.

HIPAA 98

HIPAA Compliance Regulatory Compliance ADA 98

MedTrainer

AUGUST 2, 2023

After that, the credentialing process is periodically reviewed and renewed to ensure ongoing compliance with standards and regulations. However, it’s important to remember how critical this process is for mitigating risk, improving compliance, and earning trust. Why Is Provider Credentialing Important?

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Innovaare Compliance

NOVEMBER 4, 2021

This blog is to inform California MMP Plans of the changes to the CMS 2022 protocols for MMP SARAG & MMP CDAG Universes (as it relates to Appeals & Grievances). Armed with this regulatory compliance information, you should be in a better position to create accurate universes that comply with the latest Medicare and Medicaid protocols.

Regulatory Compliance 52

Regulatory Compliance Medicaid Medicaid Medicare 52

Drug & Device Law

DECEMBER 29, 2023

2023) (rejecting any express anti-preemption presumption in Medicare case) ( here ); Baker v. This year’s Drug & Device Law Blog top ten decisions of the year reinforced preemption – the most powerful defense we can assert. Plaintiffs’ own litigation strategy thus opened the door to compliance evidence. 3d 239 (Cal.

FDA 105

FDA US Department of Health and Human Services COVID-19 Informed Consent 105