Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. Such an ongoing auditing system is crucial to a healthcare organization’s compliance program.

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Provider Trust

MARCH 13, 2023

Twenty-five people were charged with criminal wire fraud and wire fraud conspiracy for their involvement in the scheme, and these people could face up to 20 years in jail. Donna Thiel, Chief Compliance Officer at ProviderTrust, said, “It’s an opportunity to promote partnership between HR and compliance.

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American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Fraud schemes range from solo ventures to widespread activities of an institution or group.

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MedTrainer

JANUARY 31, 2024

Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program? federal government enacted the Federal False Claims Act (FCA) in 1863 during the American Civil War. It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations.

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Health Law RX

JANUARY 30, 2024

By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws.

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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. What is Healthcare Compliance? These certificates validate their expertise in monitoring and ensuring compliance within their institutions.

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Health Law Advisor

AUGUST 25, 2023

In July 2022, the New York State Office of the Medicaid Inspector General (“OMIG”) proposed extensive modifications to the regulatory requirements governing compliance programs for entities receiving “significant” Medicaid revenue (increased by these regulations from a threshold of $500,000 to $1 million).

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C&M Health Law

DECEMBER 18, 2023

Compliance policies should be developed under the direction and supervision of the compliance officer and compliance committee and should address the implementation and operation of an entity’s compliance program and processes. OIG’s updated take on the seven elements is briefly summarized below. (1)

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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. Who Governs Healthcare Compliance? Technology is sure to play a critical role in the future of healthcare compliance. Learn more about how MedTrainer can streamline your compliance.

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Healthcare Compliance Blog

FEBRUARY 15, 2022

billion in settlements and judgments have been recovered by the Department of Justice Department (DOJ) related to civil cases involving fraud and false claims in fiscal year 2021. Congress strengthened the False Claims Act by increasing incentives for whistleblowers to file lawsuits alleging false claims on behalf of the government.

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YouCompli

SEPTEMBER 13, 2023

Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic.

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AIHC

MAY 31, 2022

Health care insurance fraud is a pressing problem, causing substantial and increasing costs in medical insurance programs. To combat fraud and abuse, all levels within a medical practice, hospital or health care organization must know how to protect the organization from engaging in abusive practices and violations of civil or criminal laws.

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Hall Render

NOVEMBER 10, 2023

These ICPGs will address fraud and abuse risk areas for each specific industry subsector and compliance measures that can be taken to reduce fraud and abuse risks. OIG plans to periodically update these ICPGs to address newly identified risk areas and compliance measures and to ensure timely and meaningful guidance.

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YouCompli

AUGUST 2, 2022

Healthcare compliance history has shown that when the government disperses significant funds, audits and enforcement associated with the disbursement of those funds will shortly follow. The Federal government spent unprecedented trillions of dollars throughout the COVID public health emergency (PHE). MorseLife agreed to pay $1.75

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Healthcare Compliance Blog

APRIL 26, 2022

The Office of Inspector General (OIG) for the US Department of Health and Human Services (HHS) has made educational resources available for healthcare providers to comply with federal healthcare laws and regulations. Voluntary Compliance: OIG has several self-disclosure processes to report fraud in HHS programs.

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MedTrainer

FEBRUARY 1, 2024

A corporate compliance program in healthcare is a comprehensive set of policies, procedures, and practices that healthcare organizations establish and maintain to ensure that they operate compliant with all applicable laws, regulations, and ethical standards. Why do healthcare facilities use corporate compliance programs?

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Compliancy Group

JULY 12, 2023

Designating a compliance officer and compliance committee. Policies and Procedures Healthcare organizations must create comprehensive guidelines that outline the rules and regulations governing their operations. This individual or group plays a crucial role in implementing the compliance program effectively.

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Compliancy Group

AUGUST 31, 2023

Healthcare compliance laws play a vital role in safeguarding patients’ rights, preventing fraud and abuse, and maintaining the integrity of healthcare systems. Let’s delve into the importance of healthcare compliance laws and regulations, their impact on providers and organizations, and the guidelines governing their implementation.

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MedTrainer

NOVEMBER 14, 2023

Becoming certified in healthcare compliance is not just some letters after your name; it validates your expertise and dedication to upholding the laws, regulations, and ethical standards that govern healthcare practices. Those with the CHC are well-prepared to tackle the intricate compliance issues that arise 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? Risk Assessment. Legislation and Congressional Requests.

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MedTrainer

MARCH 8, 2024

Employee compliance training is essential to any healthcare organization’s onboarding process. It educates employees on the laws, regulations, and policies governing their work and ensures they understand their responsibilities and obligations as healthcare professionals.

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Verisys

MAY 3, 2023

Healthcare entities, especially those that receive funding from Medicaid or Medicare, must meet compliance standards set forth by the Office of Inspector General (OIG). These standards help mitigate an organization’s risk by preventing waste, fraud, and abuse. What is an effective healthcare compliance program?

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MedTrainer

AUGUST 31, 2023

Let’s delve into the world of compliance with answers to the most common compliance FAQs. What Is Healthcare Compliance? Healthcare compliance refers to the process of adhering to the laws, regulations, and ethical standards that govern the healthcare industry. What Is a Compliance Officer?

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Healthcare Law Blog

FEBRUARY 9, 2024

million to resolve a lawsuit filed by the system’s former Chief Compliance Officer, Ronald Sherman. ChristianaCare denied these allegations and claimed that Sherman was granted the necessary authority in full compliance with the CIA. Delaware-based ChristianaCare Health System (ChristianaCare) [1] recently agreed to pay $47.1

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Healthcare Law Today

FEBRUARY 3, 2023

Director of Policy & Regulatory Affairs, Homeward Cecily Harris, Deputy General Counsel, Wheel Telemedicine Fraud & Abuse Enforcement Foley Partner Lisa Noller, Chair of the firm’s Government Enforcement & Investigations Practice will join a fireside chat on telemedicine fraud & abuse enforcement trends.

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Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. Violations of the False Claims Act can result in significant financial penalties, including fines and exclusion from government healthcare programs.

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AIHC

APRIL 5, 2022

Audit Coding, Billing and Documentation for Accuracy Insurance carriers and government contractors have the authority to review any claims at any time. Due to the huge volume of claims payers receive to process, deny and pay, they have implemented various methods to track providers to detect potential waste, fraud and/or abuse.

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MedTrainer

JANUARY 31, 2024

What is Healthcare Compliance? Healthcare compliance is following and meeting the laws, regulations, and ethical standards that govern the healthcare industry. Maintaining compliance is essential for operating within the legal framework and providing high-quality patient care.

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MedTrainer

FEBRUARY 12, 2024

government collected $2.2B How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims? We’ll also highlight tools to streamline compliance processes and reduce the risk of potential legal and financial judgments. Plus it’s easy to upload your own facility-specific training as needed.

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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. Office of Inspector General (OIG).

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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. What is Healthcare Compliance? Office of Inspector General (OIG): This independent agency within the U.S.

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Healthcare Law Blog

FEBRUARY 3, 2023

New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R.

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Healthcare Compliance Blog

APRIL 13, 2022

The two men, both 51, were convicted of criminal healthcare fraud and conspiracy charges in 2019. The owner and administrator of Texas-based hospice and home health entities have been named in a multimillion-dollar whistleblower lawsuit. Failure to promptly report a false claim or kickback can result in lawsuits, fines, and other sanctions.

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AIHC

MARCH 2, 2023

I do a lot of training of compliance officers and realize the time that is being spent could be improved. At this particular time, I was also a commissioner in city government and was active among many charitable organizations. The role of Compliance Officer for an association with 200 doctors had its challenges.

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Provider Trust

AUGUST 16, 2023

The Office of Inspector General (OIG) mandates that healthcare organizations conduct regular exclusion checks to avoid severe consequences, such as civil monetary penalties (CMP), legal ramifications, and reputational risk. Non-compliance with exclusion regulations may trigger investigations by government agencies and potential legal actions.

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YouCompli

DECEMBER 11, 2023

These include the Federal Anti-Kickback Statute, the Physician Self-Referral Law, the False Claims Act, the Civil Monetary Penalty (CMP) Authorities, Exclusion Authority, Criminal Health Care Fraud Statute, and the HIPAA Privacy and Security Rules. The compliance officer should either report directly to the CEO or the Board.

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YouCompli

JANUARY 18, 2023

Featured speakers : Eric Gold , Chief, Massachusetts Attorney General’s Office Healthcare Division; Jennifer Goldstein , Managing Attorney, Medicaid Fraud Division, Massachusetts Attorney General’s Office; and Steven Sharobem , Assistant US Attorney, District of Massachusetts. Moderated by David S.

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