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. Medicare/Medicaid Compliance Reviews. The OIG collaborates with other law enforcement agencies.

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Fraud Compliance Medicaid Medicaid 98

MedTrainer

DECEMBER 7, 2023

MaineCare , operating under the Maine Department of Health and Human Services (DHHS), is the state’s Medicaid program, providing essential health coverage to eligible low-income residents, thereby enhancing access to quality healthcare services in Maine.

Compliance 52

Compliance Licensing Compliance Officers Medicaid 52

MedTrainer

MARCH 28, 2024

Healthcare Compliance Complexities The first healthcare compliance programs began in the early 20th century as a response to concerns about the quality of care provided by medical practitioners. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care.

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Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

NOVEMBER 14, 2023

Compliance officers, human resource leaders, credentialing teams, and administrators are all asking themselves these critical questions. While payments could take longer, so might Medicare/Medicaid enrollments for organizations, providers, and patients. But what does this mean for your healthcare business?

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Governance Medicaid Medicaid Medicare 52

MedTrainer

MAY 21, 2024

With the odds of a person entering your healthcare facility dealing with a behavioral or mental health issue at about 20% , new and existing clinical providers must receive behavioral health compliance training to ensure patients receive the highest quality care.

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Compliance Medicaid Medicaid HIPAA 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

MedTrainer

JANUARY 12, 2024

Here are some of the key organizations involved in regulating healthcare compliance: Centers for Medicare & Medicaid Services (CMS): CMS is a federal agency within the U.S. Department of Health and Human Services responsible for administering and regulating healthcare programs such as Medicare and Medicaid.

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Compliance Fraud Medicaid Medicaid 52

Provider Trust

JULY 25, 2022

Continuous compliance begins with automated monitoring, cross-departmental communication, and population-specific workflow. In a recent webinar , ProviderTrust Founder Michael Rosen and Chief Compliance Officer Donna Thiel detailed ways in which your organization can effectively monitor your unique provider populations.

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Electronic Medical Records Licensing Medicare Medicare 52

Provider Trust

MAY 9, 2024

But it siloed us and created a lot of duplicative work,” said the organization’s Corporate Compliance Officer. “We grew up doing what had to be done. The laws have come so fast and so furiously. Partnering with ProviderTrust allowed the client to automate their exclusion monitoring and primary source verification processes fully.

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Compliance Compliance Officers Licensing Medicaid 52

MedTrainer

FEBRUARY 12, 2024

An investigation for compliance violations may occur long after it occurred ( in some cases years !). Non-compliance can lead to significant fines, legal battles, and the loss of license or accreditation. These actions can include fines, sanctions, or even revocation of licenses or certifications.

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Compliance Licensing Governance Fraud 52

MedTrainer

DECEMBER 7, 2023

The Medical Assistance Division (MAD) within the New Mexico Human Services Department (HSD) administers the state’s Medicaid program, providing essential healthcare services and financial assistance to eligible low-income residents and families in New Mexico.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Provider Trust

JULY 17, 2023

In our recent webinar, ProviderTrust’s Chief Compliance Officer, Donna Thiel, shared her expertise and valuable feedback from the 2023 HCCA Compliance Institute. Watch the Webinar During the Keynote Speech at the HCCA Compliance Institute this year, Office of Inspector General (OIG) Christi A.

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Compliance Nursing Homes Nurses Fraud 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. Loss of Licenses: Healthcare providers may lose their professional licenses, hindering their ability to practice.

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Compliance HIPAA Governance Medicare 52

MedTrainer

SEPTEMBER 21, 2023

For healthcare facilities, ensuring compliance with regulations and maintaining high standards of patient care is of the utmost importance. One crucial aspect of this is knowing how to prepare for a CMS inspection by the Centers for Medicare & Medicaid Services. Exclusions.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

JANUARY 12, 2024

Key Changes in the History of Healthcare Compliance The face of healthcare compliance has changed dramatically in the last 100-plus years: Inception (Early 20th Century): Healthcare compliance began as a response to concerns about the quality of healthcare provided by medical practitioners.

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Compliance HIPAA Telemedicine ACA 52

MedTrainer

SEPTEMBER 8, 2023

Details of the settlement indicate the submission of false claims to Medicare, Medicaid, TRICARE, and FECA programs. Many healthcare facilities rely on reimbursements from government programs such as Medicare and Medicaid. License revocation or suspension. Loss of reimbursements.

Compliance 52

Compliance HIPAA Medicaid Medicaid 52

MedTrainer

NOVEMBER 20, 2023

The TSBEPC ensures practitioners adhere to licensing requirements and maintain high standards of competence and ethical practice. The Texas HHS oversees regulations for Medicare- and state Medicaid-funded services.

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Compliance Licensing Public Health Governance 52

YouCompli

DECEMBER 7, 2022

The OIG must exclude individuals or entities who have been convicted of the following types of crimes: Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare, Medicaid, SCHIP, or other state healthcare programs. Patient abuse or neglect.

Fraud 52

Fraud US Department of Health and Human Services Compliance Medicaid 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. Occupational Health.

US Department of Health and Human Services 52

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

MedTrainer

NOVEMBER 17, 2023

This model involves specific regulations and agreements with Medicare and Medicaid, impacting how healthcare providers in the state bill for services and receive payments. Both the Maryland Department of Health – Behavioral Health Administration and the Board of Physicians license medical and mental/behavioral health providers.

Compliance 52

Compliance Licensing Hospitals Health Insurance 52

MedTrainer

OCTOBER 16, 2023

Stark Law The Stark Law , primarily enforced by Centers for Medicare & Medicaid Services (CMS), deals specifically with physician referrals. Moreover, non-compliance can damage an organization’s reputation, leading to a loss of trust and a decline in patient numbers.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Medicaid 52

MedTrainer

OCTOBER 4, 2023

Compliance Governing Agencies There are a number of federal agencies and governing bodies responsible for passing down healthcare compliance requirements to healthcare organizations, providers, and practicing professionals. CMS plays a crucial role in overseeing federal healthcare programs, including Medicare and Medicaid.

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Compliance Fraud HIPAA Governance 52

MedTrainer

JANUARY 26, 2024

Significant fines also can be levied by the Office of Inspector General (OIG) for overbilling Medicare and Medicaid. Non-compliance includes improper hand hygiene, inadequate sterilization of medical equipment, and poor sanitation practices. These actions can lead to financial losses for patients and payers.

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

AIHC

APRIL 25, 2022

Does Your Organization Have a Trained (Certified) HIPAA Privacy/Security Officer? Your HIPAA Compliance Officer can serve as the best resource to help your organization navigate the telehealth and mobile device compliance issues facing your providers today. Click Here for Cross-State Licensing information.

HIPAA 52

HIPAA Compliance COVID-19 Compliance Officers 52

Hall Render

DECEMBER 29, 2023

Here’s a look at how 11 area hospitals ranked Kentucky’s registered nurse median salary ranks 38th in U.S. bill would allow IVF therapy for same-sex veteran marriages; VA denies coverage Cancer-killing gel, minimally-invasive brain shunts: Here are recent startups spun out of area hospitals UMass Memorial named one of top U.S.

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

Hall Render

AUGUST 25, 2023

NATIONAL AHA shares proposals for drug shortage legislation with House committee America’s biggest hospital landlord sees deals souring Babylon Health files for bankruptcy Bankruptcies mounting in troubled nursing home industry Calls grow for national patient safety board: 3 leaders weigh in CMS details plan to allow Part D beneficiaries to pay (..)

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COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

MARCH 24, 2023

Sanders pushes funding boost for rural health care Struggling to survive, the first rural hospitals line up for new federal lifeline ALABAMA AARP report puts spotlight on caregiving issues, expenses in Alabama All of Us Research Program launching new enrollment location in Dothan Local partnership to provide cancer screening for rural patients Medical (..)

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

MARCH 31, 2023

s Socially Determined aims to address potential gaps in Medicaid enrollment Lawsuits Mount Against DC Health Link Over Breach of Congress Members’ Data DC COVID-19 centers closing Friday Mayor Bowser Canceling $90 Million in Medical Debt for up to 90,000 DC Residents DELAWARE ChristianaCare CEO Dr. What happens if it disappears?

US Department of Health and Human Services 40

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