Verisys

NOVEMBER 8, 2023

CMS.gov The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the creation of a standard, unique health identifier for healthcare providers, which the NPI satisfies. While health plans may use other numbers internally, the NPI is mandatory for HIPAA transactions.

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MedTrainer

FEBRUARY 1, 2024

These programs help to promote lawful and ethical conduct within healthcare organizations and minimize the risk of legal violations, such as fraud, abuse, and other unethical behaviors. We’ll answer that question in this blog along with assessments of a good corporate compliance process. What is Corporate Compliance in Healthcare?

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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. But what exactly is considered fraud, waste, and abuse? These complaints can trigger an audit. Data Analysis and Trends.

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MedTrainer

JANUARY 26, 2024

In this blog, we will outline what is non-compliance in healthcare, highlight various non-compliance activities, and explore how healthcare compliance software plays a crucial role in combating non-compliance. This includes training modules and tools for secure data management.

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YouCompli

JANUARY 4, 2022

This includes: Expanded capacity Burden Relief Provider enrollment relief Stark Law waivers HIPAA enforcement discretion Patient inducement enforcement discretion DEA waivers Expanded telehealth coverage. Ross recommends that you review and track changes to internal policies and practices, and establish a process to completely unwind.

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Compliancy Group

MARCH 19, 2024

It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. In this blog, we’ll outline the fundamentals and importance of regulatory compliance in healthcare in the U.S. HIPAA includes several rules addressing data security and privacy that protect all patient-related data within U.S.

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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. Automated workflows decrease error and omissions, allow for continuous monitoring, create transparency through a comprehensive audit trail, and maintain HIPAA privacy and security.

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MedTrainer

JANUARY 30, 2024

The professionals who manage compliance are the front lines of preventing medical errors, deterring fraud, and staying in good standing with federal payers like the Centers for Medicare and Medicaid Services (CMS). Healthcare compliance is a critical part of any organization’s business model.

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MedTrainer

OCTOBER 23, 2023

In this blog post, we will explain healthcare compliance, shine light on its significance, and share best practices within the industry. Office of Inspector General (OIG): Prevents fraud, waste, and abuse within the department’s vast array of Department of Health and Human Services (HHS) initiatives. This agency enforces HIPAA rules.

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MedTrainer

SEPTEMBER 20, 2023

This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you want to obtain or retain CMS certification in order to be reimbursed by services provided to patients with a Medicare/Medicaid health plan, you must comply with HIPAA rules and regulations. Accreditation.

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MedTrainer

JUNE 29, 2023

Health Insurance Portability and Accountability Act (HIPAA) HIPAA focuses on protecting the privacy and security of patients’ health information, and establishes rules and standards for the use, disclosure, and safeguarding of protected health information (PHI). The Office of Civil Rights (OCR) is responsible for HIPAA enforcement.

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AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

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MedTrainer

JANUARY 31, 2024

It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. These laws require healthcare providers to establish internal controls and compliance programs to prevent fraud and abuse in the healthcare system. Who started the first healthcare compliance program?

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MedTrainer

JANUARY 30, 2024

In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them. Additionally, compliance programs address a wide range of potential issues, including fraud, waste, and abuse.

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MedTrainer

OCTOBER 4, 2023

These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. These requirements are designed to protect patient rights, privacy, and safety, as well as to prevent fraud, abuse, and other improper practices within healthcare organizations.

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MedTrainer

JANUARY 31, 2024

Certified HIPAA Professional (CHP): Several entities, such as ECFC, offer versions of a CHP certification. This designation is ideal for healthcare professionals tasked with ensuring compliance with the Health Insurance Portability and Accountability Act (HIPAA). It focuses on compliance within medical practices and clinics.

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Healthcare Law Blog

NOVEMBER 9, 2023

Thereafter, OIG said it planned to update existing industry-specific compliance program guidance (ICPG), which would include tailoring each to address fraud and abuse risk areas specific to a particular industry and describing the compliance measures that industry could take to reduce these risks [2].

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MedTrainer

JANUARY 26, 2024

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. Certified HIPAA Professional (CHP): Several entities, such as ECFC, offer versions of a CHP certification. What is Healthcare Compliance?

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American Medical Compliance

FEBRUARY 9, 2024

In this blog, we will explore the crucial role of compliance officers in healthcare organizations, shedding light on the challenges they face and the formidable responsibilities they shoulder. It is not just about following rules but about maintaining the highest standards of patient care and ethical behavior.

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MedTrainer

APRIL 22, 2024

While adherence to these guidelines is voluntary, organizations implementing effective compliance programs are better equipped to identify and address potential compliance risks, mitigate fraud and abuse, and uphold the integrity of healthcare programs and services. Ensure suppliers are adequately trained on HIPAA privacy and security rules.

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MedTrainer

JANUARY 31, 2024

In this blog, we’ll discuss the structured framework for managing risks and maintaining the highest standards of care and integrity in the healthcare industry. For the organization itself, compliance programs are the guardians that can help potentially prevent medical errors and regulatory violations, and mitigate other compliance risks.

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MedTrainer

JANUARY 12, 2024

The protection of patient data, adherence to privacy regulations like the Health Insurance Portability and Accountability Act (HIPAA) in the United States, and the prevention of cyber threats have become paramount concerns. Compliance in healthcare began to encompass billing, fraud, and abuse prevention.

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Medisys Compliance

NOVEMBER 6, 2023

This blog will provide a comprehensive orthopedic billing compliance checklist that healthcare providers can use to verify that their billing practices are compliant with all applicable laws and regulations. Stay up-to-date on all changes to regulatory requirements. Staying compliant with evolving regulations is critical.

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MedTrainer

JANUARY 26, 2024

That’s where MedTrainer comes in handy as an all-in-one software compliance solution From HIPAA to OSHA, MedTrainer’s policy experts stay on top of changes and continually update courses that are created specifically for healthcare organizations. Why Is Compliance Training and Education Important?

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MedTrainer

AUGUST 31, 2023

It also helps prevent fraud, abuse, and errors, ensuring the delivery of high-quality care and ethical decision-making. What Is HIPAA and How Does It Impact Healthcare Compliance? A Security Risk Analysis (SRA) is a mandatory requirement under the HIPAA Security Rule. What Are the Consequences of Non-Compliance?

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MedTrainer

OCTOBER 17, 2023

In this blog post, we’ll discuss the answer to: “Why do healthcare facilities have corporate compliance programs?” Prevention of Fraud and Abuse Corporate compliance works as a shield against potential fraud and abuse. Compliance programs ensure that facilities handle this data with care.

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Verisys

JANUARY 8, 2024

This includes adherence to standards set by the Health Insurance Portability and Accountability Act (HIPAA) , the Centers for Medicare & Medicaid Services (CMS), and other regulatory bodies. The audit evaluates if the healthcare organization follows billing and coding standards to prevent fraud and abuse.

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Compliancy Group

JANUARY 17, 2024

In this blog post, we look closely at the intricacies of the Plan, exploring how it shapes the healthcare compliance landscape. Department of Health and Human Services (HHS), is tasked with combating fraud, waste, and abuse in health programs, ensuring efficiency, and promoting the integrity of HHS programs, including Medicare and Medicaid.

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MedTrainer

NOVEMBER 14, 2023

Legal and Regulatory Risks: Non-compliance with laws and regulations like HIPAA can lead to fines, penalties, and legal expenses. Financial Risks: They encompass losses from billing errors, fraud, and abuse claims, or failed investments related to healthcare provisions.

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Verisys

FEBRUARY 12, 2024

This includes clinical risks, financial risks, cybersecurity threats, and compliance risks with laws and regulations such as HIPAA (Health Insurance Portability and Accountability Act) in the United States.

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MedTrainer

FEBRUARY 1, 2024

Here’s how these plans help limit liability: Prevent Fraud and Abuse: Compliance plans include measures to prevent fraud and abuse within the healthcare organization. HIPAA in the U.S.), and quality of care.

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MedTrainer

MARCH 8, 2024

Below are courses that are common to many roles in long-term care facilities that meet federal requirements for orientation or annual continuing education. Staff should review requirements for their specific state to remain in compliance.

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Hall Render

JANUARY 11, 2023

The Health Breach Notification Rule applies only to organizations not subject to HIPAA and is triggered when there is unsecured, individually identifiable information in a PHR. Health Information Technology – FAQs on HIPAA and health IT.

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MedTrainer

JANUARY 26, 2024

Denied Claims: Failure to comply with coding and billing regulations can lead to denied claims, delayed reimbursement, or even accusations of fraud. Reputational Damage: Violating regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) can result in significant fines and reputation damage.

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MedTrainer

NOVEMBER 14, 2023

Certified HIPAA Professional (CHP) : Offered by organizations such as ECFC, the CHP designation is tailored for those responsible for aligning healthcare operations with the Health Insurance Portability and Accountability Act (HIPAA), focusing on the confidentiality and security of patient information.

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MedTrainer

NOVEMBER 2, 2023

Health Insurance Portability and Accountability Act (HIPAA) HIPAA ensures the privacy of patient health information. Having intimate knowledge of HIPAA laws, rules, and consequences for non-compliance aid healthcare compliance officers in keeping their staff and organization compliant.

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AIHC

MAY 24, 2022

I also recommend reading When Healthcare White-Collar Crimes Turn Red , an AIHC blog article from 2021. Internal Investigations are conducted by skilled employees (or a consultant under contract working for the organization) trained to perform specialized audits to gather evidence when there is suspected fraud, abuse or crime.

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