HIPAA Journal

JANUARY 30, 2023

The National HIPAA Summit is the leading forum on healthcare EDI, privacy, breach notification, confidentiality, data security, and HIPAA compliance, and the deadline for registration for the Virtual 40th National HIPAA Summit is fast approaching.

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HIPAA Journal

MARCH 30, 2023

While the seven elements of a compliance program apply to all industries, they originated in the healthcare industry in the 1990s. This was in response to the growing level of healthcare fraud and abuse and an alleged “compliance disconnect” at the executive level in many hospitals and health systems.

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Compliancy Group

MARCH 21, 2024

Office of Inspector General (OIG) of the Department of Health and Human Services (DHHS) oversees regulations covering federal programs offering benefits to healthcare organizations. All these tasks can seem daunting to even the most organized compliance officers. For example, how do they make the training engaging and memorable?

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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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MedTrainer

JANUARY 10, 2024

Review Recent Compliance Changes There is a major shift in compliance priorities toward addressing health inequities and improving access to quality healthcare services. The OIG is making major investments to systematically detect and prosecute fraud. We all should be a LOT more prepared!

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MedTrainer

JANUARY 31, 2024

This certification, offered by the CCB, showcases a deep understanding of compliance, ethics, and risk management principles, making it highly relevant for healthcare compliance roles. Certified HIPAA Professional (CHP): Several entities, such as ECFC, offer versions of a CHP certification.

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MedTrainer

JANUARY 30, 2024

Healthcare compliance is a critical part of any organization’s business model. 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).

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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

Compliance Officers: Healthcare compliance officers , responsible for overseeing and enforcing compliance within healthcare organizations, often hold healthcare regulatory compliance certificates. These certificates validate their expertise in monitoring and ensuring compliance within their institutions.

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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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Compliancy Group

JULY 12, 2023

Organizations must establish and implement an effective compliance program encompassing seven key elements to achieve this. Let us delve into these essential components and understand how they contribute to upholding healthcare compliance requirements. Designating a compliance officer and compliance committee.

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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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MedTrainer

OCTOBER 23, 2023

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. Office for Civil Rights (OCR) : Provides oversight of the safe and ethical handling of patient data and privacy. This agency enforces HIPAA rules.

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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

AUGUST 31, 2023

Compliance is crucial in healthcare to safeguard patients’ well-being, maintain trust in the industry, and avoid legal and financial repercussions. 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?

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MedTrainer

SEPTEMBER 8, 2023

This certification showcases a deep understanding of compliance, ethics, and risk management principles, making it highly relevant for healthcare compliance roles. Certified HIPAA Professional (CHP): Several entities, such as ECFC, offer versions of a CHP certification.

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YouCompli

DECEMBER 19, 2023

HIPAA Privacy and Security Rules (page 30): In bold print, the OIG recommends that compliance with Privacy, Security and Breach Notification Rule requirements be included in ALL risk assessments. Effective communication and collaboration between compliance and legal is the key to a successful outcome.

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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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MedTrainer

JANUARY 31, 2024

Who started the first healthcare compliance program? It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. However, it wasn’t until the mid-20th century that healthcare compliance regulations and programs began. What is Healthcare Compliance?

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YouCompli

NOVEMBER 29, 2023

“As previous OIG compliance guidance(s) are retired to ‘archival’ status, we all should recognize that the original guidance may have been the most important document ever written for healthcare compliance professionals.” — Roy Snell In 1998, the Office of Inspector General (OIG) issued its first General Compliance Program Guidance (GCPG).

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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

FEBRUARY 1, 2024

A “red flag” in healthcare compliance refers to a warning sign or indicator that suggests a potential issue or violation of healthcare laws, regulations, or policies. These red flags are used to identify situations or activities that may raise concerns about fraud, waste, abuse, or non-compliance with healthcare regulations.

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MedTrainer

MARCH 8, 2024

Specific topic areas include: HIPAA: The Health Insurance Portability and Accountability Act is a federal law that governs the privacy and security of patient health information. Compliance training should cover the key provisions of HIPAA, including the Privacy Rule, Security Rule, and Breach Notification Rule.

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Medisys Compliance

JANUARY 30, 2023

Let us discuss the top compliance issues in the medical billing industry, shall we? HIPAA: The Health Insurance Portability and Accountability Act( HIPAA) is a federal law that establishes the national standards for protecting the privacy and security of individuals’ personal health information ( PHI).

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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.

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MedTrainer

OCTOBER 17, 2023

Here are a few areas that a well-established compliance program can influence a healthcare organization. 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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Healthcare Blog

NOVEMBER 9, 2023

Such a program assures compliance with applicable laws, regulations, and industry standards, reducing the risk of legal and financial ramifications. A strong compliance program assists organizations in navigating this complicated landscape while avoiding potential breaches and penalties.

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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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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 4, 2022

They provide great insight for Compliance practitioners. This includes: Expanded capacity Burden Relief Provider enrollment relief Stark Law waivers HIPAA enforcement discretion Patient inducement enforcement discretion DEA waivers Expanded telehealth coverage.

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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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MedTrainer

JANUARY 26, 2024

Here are some common non-compliance activities: Failure to Maintain HIPAA Compliance: The Health Insurance Portability and Accountability Act (HIPAA) sets strict guidelines for safeguarding patient health information. This includes training modules and tools for secure data management.

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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. The role of Compliance Officer for an association with 200 doctors had its challenges. I have also added the CFE, Certified Fraud Examiner through the Association of Certified Fraud Examiners.

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MedTrainer

JANUARY 26, 2024

Why Is Compliance Training and Education Important? Ensure Relevant and Up-To-Date Healthcare Compliance Training In today’s fast-paced healthcare environment, it’s hard for employers to stay on top of required compliance training and changing regulations.

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MedTrainer

JANUARY 31, 2024

Maintaining compliance is essential for operating within the legal framework and providing high-quality patient care. By ensuring accurate billing and coding practices, compliance programs protect healthcare organizations from legal and financial repercussions.

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MedTrainer

MARCH 8, 2024

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

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MedTrainer

FEBRUARY 1, 2024

How Medical Compliance Plans Limit Liability of Healthcare Organizations Medical compliance plans help staff remain compliant, protect patients, and reduce liability to an organization’s reputation and financial stability. HIPAA in the U.S.), and quality of care.

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