The Health Law Firm Blog

DECEMBER 3, 2023

Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. Indest III, J.D., In many cases, the individuals involved [.]

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MedTrainer

FEBRUARY 12, 2024

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. Non-compliance can lead to significant fines, legal battles, and the loss of license or accreditation.

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The Health Law Firm Blog

SEPTEMBER 8, 2022

Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. Indest III, J.D., In many cases, the individuals involved [.].

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Licensing Governance Health Care Lawyers Medicaid 52

The Health Law Firm Blog

SEPTEMBER 8, 2022

Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. Indest III, J.D., In many cases, the individuals involved [.].

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Licensing Governance Health Care Lawyers Medicaid 52

MedTrainer

MAY 6, 2024

This blog will highlight how credentialers can navigate Aetna provider enrollment. Built-in Automation: Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration.

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Licensing Malpractice Health Insurance Medicaid 52

Verisys

FEBRUARY 9, 2024

Million Full Story Doctor Agrees to Pay $95,000 to Settle Allegations of Health Care Fraud Full Story Columbia Physician Indicted for False Statements to Medicare Full Story Pharmacist Fraud Current and Former Owners of Center City Philadelphia Pharmacy Agree to Pay Over $4.6

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MedTrainer

NOVEMBER 14, 2023

In this blog post, we’ll explore the many reasons why healthcare compliance isn’t just important — it’s vital. Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. What Is Healthcare Compliance?

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MedTrainer

FEBRUARY 20, 2024

In this blog, we’ll review what is insurance credentialing, the process, and who’s required to complete insurance credentialing. While these professions do require credentialing, many other licensed healthcare providers require insurance credentialing as well. There are many steps to this time-consuming process.

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Pharmacy Law Blog

MAY 14, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

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Pharmacy Law Blog

MAY 7, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

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MRO Compliance

JUNE 1, 2022

HEDIS (Healthcare Effectiveness and Data Information Set) is part of a review process for Medicare Advantage plan quality measures. HEDIS works as a government rating tool. Depending on the score of a health plan, payers may receive considerable Medicare financial incentives if a score exceeds a certain level. Data integrity.

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Verisys

MARCH 30, 2023

How to Better Protect your Organization Through Medical Credentialing Medical credentialing – the tedious but necessary process of verifying a provider’s credentials, including license(s) and exclusion status, education, and training. Medical credentialing , unfortunately, isn’t one-and-done at the time of hire.

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MedTrainer

JANUARY 12, 2024

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. Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry.

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Compliance Fraud Medicaid Medicaid 52

Bill of Health

FEBRUARY 23, 2023

Over the course of the COVID-19 pandemic, now entering its fourth year in 2023, legislators, executives, and judges at every level of government have sought measures to derail efficacious public health interventions. By James G. Denialist interventions were also contested under existing federal or state disability protections.

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Provider Trust

AUGUST 9, 2022

This year’s 129-page report also includes information about the amounts deposited and appropriated to the Medicare Trust Fund, as well as the source of such deposits. During the fiscal year 2021, the report states that the federal government won or negotiated over $5 billion in healthcare fraud judgments and settlements. Of this $1.9

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Verisys

DECEMBER 5, 2023

State licensing boards verify practitioner license type and status. An Office of Inspector General (OIG) search of the List of Excluded Individuals/Entities (LEIE) indicates if the licensee is excluded from participating in government-funded programs. Here are some examples: Medical schools verify completion of education.

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Healthcare Law Blog

APRIL 13, 2022

However, in all states, the NSA governs disputes relating to air ambulance services, not state law. Federal law governs disputes relating to out-of-network services provided by air ambulance providers. Background of the NSA. AB 72 also limits the enrollee’s cost-sharing amount to the enrollee’s in-network rate.

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Governance Medical Billing Licensing Medicare 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. What is healthcare data governance? What is GRC in Healthcare?

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Verisys

NOVEMBER 30, 2022

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. License Verification & Monitoring. Medicare opt out. Medicare and Medicaid Opt-Outs. Medicare and Medicaid Opt-Outs. Credentialing.

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MedTrainer

DECEMBER 7, 2023

For example, the Office of Health Care Assurance (OHCA) is one governing body that healthcare professionals need to understand in order to manage organizational licensure and healthcare compliance in Hawaii effectively. As with any inter-state provider pact, physicians are required to meet the licensing requirements of the pact.

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MedTrainer

DECEMBER 7, 2023

State-specific governing bodies, such as the Bureau of Facility Standards , provide oversight with certain standards, adding a layer of complexity to successfully managing healthcare compliance in Idaho. Telehealth appointments are fully reimbursable so long as the provider is licensed in the patient’s state.

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YouCompli

JUNE 29, 2022

“Not surprisingly, both government and health plan audits have identified what Compliance professionals warmly refer to as ‘opportunities’ with respect to how telehealth services are documented, coded, and reimbursed by healthcare providers.” . Legislation to watch includes the? Telehealth Extension Act of 2021 (H.R.

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MedTrainer

MARCH 28, 2024

In this blog, we’ll outline the many roles that impact healthcare compliance , the pros and cons of each role’s management responsibilities, and what each is accountable for in concert with the others. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care.

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Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). With a few exceptions, the Final Rule is a wholesale codification of the proposed rule.

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MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. So, how has the history of healthcare compliance changed since its inception?

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YouCompli

AUGUST 29, 2023

Health and Human Services Office of Inspector General (OIG) found that Medicare beneficiaries used 88 times more telehealth services during the first year of the pandemic than they did the previous year. million in Medicare fee-for-service payments. million in Medicare fee-for-service payments. It involved an estimated $1.2

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YouCompli

JULY 12, 2022

Wolf, MD provides enforcement action summaries for the YouCompli blog. In fact, Medicare beneficiaries used telehealth to receive 12 percent of their services during the first year of the pandemic. This was more than two in five Medicare beneficiaries. This month’s article looks at telehealth actions. billion in alleged losses.

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MedTrainer

NOVEMBER 27, 2023

Ohio Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Ohio Department of Health (ODH) is key to safeguarding and enhancing the health of Ohio residents. The State Medical Board of Ohio provides licensing and regulatory guidelines for medical providers in Ohio State.

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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. Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry.

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MedTrainer

DECEMBER 7, 2023

The New Mexico Medical Board is responsible for licensing and regulating medical practitioners in the state, ensuring that they meet professional standards for safe and ethical medical practice. This article is your guide to the important aspects of healthcare compliance in New Mexico with strategic insights for effective management.

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MedTrainer

NOVEMBER 20, 2023

Texas Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Texas Department of State Health Services (DSHS) plays a crucial role in promoting the health and wellbeing of Texans. The Texas HHS oversees regulations for Medicare- and state Medicaid-funded services.

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Compliance Licensing Public Health Governance 52

MedTrainer

JULY 28, 2023

OIG Inspections in Healthcare The OIG focuses its resources on oversight of Medicare and Medicaid — programs that represent a large portion of the federal budget. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers. Tips and Leads From Law Enforcement Agencies.

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Verisys

MAY 9, 2023

These regulatory programs ensure that reimbursement happens only for licensed practitioners and healthcare entities in good standing with the Office of Inspector General (OIG). Healthcare organizations must align their practices to comply with OIG regulations.

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Provider Trust

JULY 26, 2022

District Attorney alleges that Pickering was hired in 2019 as a licensed physician’s assistant at a family practice in Norcross, Georgia but had not been a licensed physician’s assistant in Georgia, or any state, since March 2014. The Importance of Conducting License Verification and Monitoring. According to the U.S.

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YouCompli

JULY 26, 2023

Health and Human Services Office of Inspector General (OIG) found that Medicare beneficiaries used 88 times more telehealth services during the first year of the pandemic than they did the previous year. million in Medicare fee-for-service payments. billion in Medicare funds for orthotic braces in the 20 months that followed. 

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Verisys

DECEMBER 13, 2023

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Verisys provides robust identity verification and ongoing monitoring for individuals and entities, safeguarding your business from potential risks.

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Verisys

NOVEMBER 14, 2023

Primary source verification must be done to confirm a provider’s education, professional license and certifications, medical training, work history, references, and more. Provider information should be continuously monitored for any changes to exclusion or license status.

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