MedTrainer

NOVEMBER 14, 2023

While federal operations are slowed, reduced, or put on pause during a government shutdown, healthcare services must continue to operate. Compliance officers, human resource leaders, credentialing teams, and administrators are all asking themselves these critical questions. What Is a Government Shutdown?

Governance 52

Governance Medicaid Medicaid Medicare 52

HIPAA Journal

NOVEMBER 17, 2022

HIPAA Journal is conducting interviews with healthcare professionals and service providers to find out more about their compliance journeys, how the HIPAA Rules have affected their working lives, and the successes and challenges they have faced with HIPAA compliance. Tell the readers about your career in the healthcare industry.

Governance 88

Governance HIPAA Compliance Nursing Homes 88

Health Law Advisor

OCTOBER 5, 2022

Thus, she emphasized that “if a cooperating company discovers hot documents or evidence [during a government investigation], its first reaction should be to notify the prosecutors.”. that the compliance program is “reasonably designed and implemented.”.

Compliance Officers 52

Compliance Officers Compliance Due Diligence Governance 52

Compliancy Group

JANUARY 16, 2024

Let’s dive right into the significance behind these solutions, emphasizing the role of the Compliance Officers (COs) in reporting to the Board of Directors and the importance of compliance training for the Board. This open line of communication fosters a culture of accountability throughout the organization.

Compliance 52

Compliance Compliance Officers Regulatory Compliance Regulations Compliance 52

Compliancy Group

APRIL 17, 2024

For example, the OIG has focused on billing and coding, quality of care, data security and privacy, and Medicare compliance. Compliance officers and other healthcare leaders should stay updated on these focus areas and be able to anticipate annual changes in audit policy.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

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)

Compliance 52

Compliance Compliance Officers Governance Overpayments 52

MedTrainer

APRIL 16, 2024

Healthcare compliance auditing software helps compliance managers prepare their organization for an audit. As the regulatory landscape evolves, having robust healthcare compliance software to ensure you’re audit-ready will become increasingly important for compliance officers in 2024.

Compliance 52

Compliance Compliance Officers Regulatory Compliance Governance 52

MedTrainer

APRIL 22, 2024

A healthcare compliance committee is a cross-functional team that monitors compliance at a strategic level. An influential healthcare compliance committee supports the compliance officer in promoting ethical practices, mitigating risks, and advising on compliance program operations.

Compliance 52

Compliance Compliance Officers Governance Medicaid 52

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.

Regulatory Compliance 52

Regulatory Compliance Compliance Compliance Officers HIPAA 52

Compliancy Group

APRIL 24, 2024

Why Compliance Monitoring Matters Healthcare regulations are continually evolving. Staying ahead means understanding these regulations and actively monitoring compliance across all levels of an organization. From hiring and safety to data governance, it all matters.

Compliance 59

Compliance Compliance Officers Compliance Framework Hospitals 59

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).

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

Verisys

MAY 3, 2023

For guidance on your specific healthcare industry segment, see OIG’s compliance program guidance documents. What is an effective healthcare compliance program? Designate an employee as the compliance officer and form a compliance committee. Measuring effectiveness: Who is your designated compliance officer?

Compliance 52

Compliance Compliance Officers ADA Governance 52

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

COVID-19 Vaccine 52

COVID-19 Vaccine COVID-19 Nursing Homes Compliance Officers 52

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.

Compliance 52

Compliance Compliance Officers HIPAA Governance 52

MedTrainer

DECEMBER 7, 2023

All healthcare organizations, along with their providers and compliance officers, must understand the requirements of each regulatory state agency that provides oversight. This article offers a summary of essential aspects of healthcare compliance specific to Hawaii.

Compliance 52

Compliance Compliance Officers Licensing Medicaid 52

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.

Compliance 52

Compliance Compliance Officers Fraud Governance 52

Hall Render

NOVEMBER 10, 2023

Many of the compliance program provisions in the GCPG reinforce best practices and recommendations from previous CPGs, as well as insights learned from Corporate Integrity Agreements (“CIAs”) and various other OIG guidance. Below we provide some of the compliance guidance memorialized in the GCPG: 1.

Compliance 40

Compliance Compliance Officers Fraud Governance 40

MedTrainer

JULY 13, 2023

Laws Are Behind the Technology Governing bodies are racing to keep up with the AI evolution, but very few have released policies to help guide compliance professionals. Maintaining Healthcare Compliance As Technology Evolves As a healthcare compliance officer, you’re in a tough position.

Compliance 52

Compliance Compliance Officers FDA Governance 52

YouCompli

MAY 24, 2023

Tips for Compliance Officers to Manage Risk A patient undergoes surgery requiring a medical device. Routine occurrences – and a potential compliance issue if it looks like financial kickbacks are involved. In this case, a laboratory settled allegations by paying the government millions of dollars.

Compliance Officers 52

Compliance Officers Compliance Doctors Due Diligence 52

YouCompli

JUNE 29, 2022

With it, compliance officers have guided their healthcare organizations in complying with changing documentation, coding, and confidentiality requirements. As virtual care requirements for telehealth evolve, we explore how compliance officers can support patient care and help their organizations stay up to date.

Compliance Officers 52

Compliance Officers Compliance Telemedicine Medicare 52

MedTrainer

OCTOBER 16, 2023

At its core, a healthcare compliance program is a systematic approach designed to meet medical compliance guidelines. It ensures that healthcare organizations and their staff adhere to the myriad of federal and state regulations, industry standards, and internal policies governing their operations.

Compliance 52

Compliance Compliance Officers Governance Hospitals 52

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.

Compliance 52

Compliance Compliance Officers Fraud HIPAA 52

YouCompli

AUGUST 2, 2023

As compliance officers, we talk a lot about the factors that directly influence a culture of compliance in our organizations. But we don’t spend nearly as much time on elements that affect compliance culture more indirectly.  non-medical factors that influence patients’ health outcomes) can influence compliance rates.

Compliance 52

Compliance Compliance Officers Health Outcomes Hospitals 52

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?

Compliance 52

Compliance Compliance Officers HIPAA Fraud 52

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. Continue reading this overview for key aspects of healthcare compliance specific to the state of Idaho.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

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.

Compliance 52

Compliance Fraud Governance ACA 52

MedTrainer

JANUARY 26, 2024

In this blog, we’ll outline the seven key components of compliance in healthcare and how MedTrainer helps manage these processes. In this on-demand webinar, veteran compliance office Suzi Gausman shares her top compliance priorities as they relate to the seven components of compliance.

Compliance 52

Compliance Compliance Officers Governance Hospitals 52

MedTrainer

AUGUST 9, 2023

Be proactive and view a checklist of the “Top Compliance Risks That Should Be Shared With Your Governing Body.” How Does Healthcare Risk Management Software Help Organizations Identify and Mitigate Risks? Risk managers and compliance officers can define specific metrics, parameters, and data points to be included in the reports.

Regulatory Compliance 80

Regulatory Compliance Compliance Compliance Officers Health Insurance 80

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

Hospitals 52

Hospitals Compliance Officers Compliance Overpayments 52

YouCompli

NOVEMBER 1, 2023

As compliance officers, we are continually placed in a position to influence the actions of others and help shape our organization’s compliance culture. One way to change that perception is to avoid creating “gotcha” moments when you’re working on a compliance-related matter.

Compliance 52

Compliance US Department of Health and Human Services Compliance Officers Overpayments 52

MedTrainer

MARCH 28, 2024

This is one of seven components recommended in the OIG’s compliance guidelines. In large healthcare organizations, a compliance officer is typically responsible, however, in smaller organizations, such as physician practices, a case could be made for the entity’s compliance contact to be in one of several different roles.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

JUNE 28, 2023

The primary goal of a Certified Fraud Examiner in healthcare is to safeguard the integrity of healthcare systems and protect patients, insurance providers, and government programs from financial losses due to fraudulent activities. Typically, that means looking at the five main Federal laws governing healthcare fraud : False Claims Act (FCA).

Fraud 52

Fraud Compliance Governance Compliance Officers 52

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.

US Department of Health and Human Services 52

US Department of Health and Human Services Compliance Officers Compliance Fraud 52

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.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52

YouCompli

MARCH 22, 2023

For example, the government regularly asserts Medicare claims must be “reasonable and necessary for the diagnosis or treatment of an illness or injury.” The government argued that before ordering definitive UDT, a provider first needs to review the results of the presumptive test. Some were never tested at all.

Overpayments 52

Overpayments Overpayment Compliance Medicare 52

YouCompli

OCTOBER 11, 2022

Demonstrate Compliance’s impact with a sales mentality and culturally impactful metrics. Healthcare compliance officers know the value their work and regulatory change management bring to their organization. Being an effective influencer and using culturally impactful metrics can help tell Compliance’s story.

Compliance 52

Compliance Compliance Officers HIPAA Hospitals 52

AIHC

MAY 31, 2022

When the federal government covers items or services rendered to Medicare and Medicaid beneficiaries, the federal fraud and abuse laws apply. Government programs, such as the Centers for Medicare & Medicaid Services (CMS), find the investment in their audit and monitoring programs are effective.

Fraud 52

Fraud Compliance Officers Compliance Medicare 52