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).

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

Compliancy Group

AUGUST 31, 2023

They cover various aspects, including: Internal Monitoring Systems Employee Training Programs Reporting Mechanisms for Potential Violations Health Insurance Portability and Accountability Act (HIPAA) HIPAA focuses on safeguarding the privacy and security of patients’ health information.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52

MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

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. Centers for Medicare and Medicaid (CMS) : Evaluates providers’ adherence to state/federal regulations and guidelines at both the individual and organizational levels.

Compliance 52

Compliance Compliance Officers Fraud Governance 52

AIHC

NOVEMBER 6, 2023

The focus of this article is to “connect the dots” between Health Insurance Portability & Accountability Act (HIPAA) and HITECH regarding privacy and security of electronically protected health information (ePHI). However, your organization should not address only “HIPAA” or only “HITECH”. What is “HITECH”?

HIPAA 59

HIPAA Compliance Governance Health Insurance 59

MedTrainer

JANUARY 30, 2024

Compliance is Mandatory for Federal Programs One constant is that organizations and facilities that participate in federal healthcare programs, such as Medicare and Medicaid, must have a compliance program. Laboratories: Clinical laboratories that perform tests covered by Medicare or Medicaid.

Governance 52

Governance Compliance Nursing Homes Medicaid 52

MedTrainer

DECEMBER 7, 2023

The Medicaid and Health program of Idaho provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities in the state, offering a range of medical and health-related services.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

MedTrainer

FEBRUARY 1, 2024

Ensure Legal and Regulatory Compliance: This helps healthcare facilities stay in compliance with federal, state, and accreditation regulations, including laws like the Health Insurance Portability and Accountability Act (HIPAA). Monitoring and Auditing: Monitor for adherence to policies and regulations.

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 52

AIHC

NOVEMBER 6, 2023

The focus of this article is to “connect the dots” between Health Insurance Portability & Accountability Act (HIPAA) and HITECH regarding privacy and security of electronically protected health information (ePHI). However, your organization should not address only “HIPAA” or only “HITECH”. What is “HITECH”?

HIPAA 52

HIPAA Compliance Governance Health Insurance 52

MedTrainer

NOVEMBER 14, 2023

Exclusion from Government Programs: Entities found non-compliant may be barred from participating in government healthcare programs like Medicare and Medicaid. Criminal Charges: Knowingly committing compliance violations can lead to criminal charges against individuals responsible.

Compliance 52

Compliance HIPAA Governance Medicare 52

MedTrainer

MARCH 28, 2024

Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations. This is one of seven components recommended in the OIG’s compliance guidelines. For all-size organizations, the owner(s)/executive team has a legal and ethical responsibility to maintain compliance.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

SEPTEMBER 8, 2023

These two healthcare compliance news stories — and many others — highlight the significant damage that can come from non-compliance or a willful violation of compliance standards. This settlement was the largest HIPAA settlement at that time. Loss of reimbursements. License revocation or suspension. Patient privacy.

Compliance 52

Compliance HIPAA Medicaid Medicaid 52

MedTrainer

JUNE 28, 2023

CFEs collaborate with various stakeholders — including compliance officers, legal teams, auditors, and law enforcement agencies — to address fraud and compliance-related issues. The FCA prohibits submitting false or fraudulent claims for payment to government healthcare programs, such as Medicare and Medicaid.

Fraud 52

Fraud Compliance Governance Compliance Officers 52

MedTrainer

JANUARY 26, 2024

It jeopardizes patient health, and can seriously harm the legal standing and reputation of healthcare institutions. 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.

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

MedTrainer

OCTOBER 4, 2023

These federal compliance governing agencies regulate the industry at the national level: Centers for Medicare & Medicaid Services (CMS). CMS plays a crucial role in overseeing federal healthcare programs, including Medicare and Medicaid. Office for Civil Rights (OCR).

Compliance 52

Compliance Fraud HIPAA Governance 52

Verisys

JANUARY 19, 2022

According to recent surveys of major metropolitan hospitals , departments that typically share the responsibility for credentialing include: The Compliance Office. Checks credentialing for Health Insurance Portability and Accountability Act (HIPAA) compliance. Human Resources. Medical Staffing Services.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Malpractice Compliance Officers 52

MedTrainer

OCTOBER 16, 2023

Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a pivotal regulation that focuses on the protection of patient health information, enforced by the U.S. Department of Health and Human Services (HHS). What Are the Penalties for Non-Compliance in Healthcare? million annually.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Medicaid 52

MedTrainer

NOVEMBER 29, 2023

The Tennessee Hospital Association (THA) is a membership organization that represents and supports hospitals and health systems across Tennessee, advocating for their interests and working to enhance healthcare quality and accessibility for all Tennesseans. TennCare is Tennessee’s managed Medicaid agency.

Compliance 52

Compliance Licensing HIPAA Medicaid 52

MedTrainer

JUNE 29, 2023

This helps you ensure compliance with various (ever-changing) healthcare regulations, including those posed by: Centers for Medicare and Medicaid Services (CMS) Health Insurance Portability and Accountability Act (HIPAA) Occupational Health and Safety Administration (OSHA) Food and Drug Administration (FDA) Office of Inspector General (OIG) General (..)

Compliance 52

Compliance FDA Health Insurance Medicaid 52

MedTrainer

NOVEMBER 15, 2023

Department of Health and Human Services The United States Department of Health and Human Services (HHS) is the primary federal agency responsible for protecting the health of all Americans and providing essential human services. Office for Civil Rights The Office for Civil Rights (OCR) is another branch of HHS.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

MedTrainer

AUGUST 2, 2023

They review healthcare claims and billing practices to ensure accuracy, detect fraud or abuse, and assess compliance with the payer’s policies and guidelines. Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS).

Compliance 52

Compliance ACA Medicaid Medicaid 52

Hall Render

DECEMBER 29, 2023

hospitals for maternity care UMass Memorial Medical Center to reinstate caregiver mask mandate Massachusetts health system sees over $17M FY ’23 profit Mass. hospitals for maternity care UMass Memorial Medical Center to reinstate caregiver mask mandate Massachusetts health system sees over $17M FY ’23 profit Mass.

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses COVID-19 40