Compliancy Group

JUNE 6, 2024

Many compliance violations in healthcare arise from financial conflicts of interest, particularly when providers get kickbacks or achieve financial gain from their referral services. As with all healthcare compliance regulations, those pertaining to Stark Law DHS undergo constant updates.

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Compliance Officers Compliance US Department of Health and Human Services Medicare 59

Verisys

FEBRUARY 23, 2022

As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. Accordingly, maintaining compliance has become a key focus for healthcare facilities. Training employees on compliance issues.

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MedTrainer

APRIL 11, 2024

There is one way to describe the relationship between HR professionals and compliance officers: It’s complicated. As you see these roles work together, you might wonder about the difference between a compliance officer and human resources in healthcare.

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MedTrainer

NOVEMBER 2, 2023

This critical responsibility rests on the shoulders of the healthcare compliance officer. Read on if you’ve ever wondered about the unsung heroes as we answer the question: What does a compliance officer do in healthcare? What Is the Primary Role of a Compliance Officer in Healthcare?

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Healthicity

JUNE 23, 2022

As compliance officers, we often focus (and rightfully so) on enforcement efforts.

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Provider Trust

APRIL 22, 2025

Since its founding in 2010 by Christopher Redhage, Michael Rosen, and Andrew Luers, ProviderTrust has been at the forefront of healthcare data innovation, transforming outdated compliance practices into real-time, data-driven intelligence. Because when the data is right, healthcare works better for everyone.

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MedTrainer

AUGUST 8, 2024

In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Why Additional Training Is Required for Medicare-Enrolled Providers Training helps providers understand and adhere to Medicare’s complex regulations and guidelines, essential for maintaining compliance.

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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. Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1]

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Provider Trust

MAY 26, 2023

Thursday, June 22, 2023 | 12-1pm CST Join us for an information session where Donna Thiel, Chief Compliance Officer at ProviderTrust, will share her expertise and valuable feedback from the 2023 HCCA Compliance Institute.

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MedTrainer

FEBRUARY 7, 2024

The complex world of healthcare compliance demands a clear understanding of responsibilities. For those new to the role of compliance officer, the question often arises: “Who is responsible for compliance in healthcare?” Who is Responsible for Compliance in Healthcare?

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Health Law Advisor

AUGUST 25, 2023

It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. These regulations were proposed to implement portions of the New York State 2020-2021 Budget Bill amending the mandatory compliance program requirements. New York Social Services Law § 363-d.

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Verisys

MARCH 6, 2025

Proper provider credentialing also assists in compliance with industry regulations and maintaining accreditation. Further, the failure of a hospital to verify a practitioners qualifications can have a direct impact on patient safety, regulatory compliance, and the operational success of healthcare organizations.

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Compliancy Group

MARCH 12, 2025

With such a wide range of potential noncompliance incidents, more compliance officers are exploring ways to combat these penalties so they can respond proactively instead of reactively. Such noncompliance can result in non compliance fines. Using compliance software can prevent upcoding.

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Verisys

MARCH 6, 2025

Healthcare executives and compliance officers must consistently update and verify provider data to enhance patient care, adhere to regulatory standards, and streamline administrative tasks. These small discrepancies can cause major disruptions down the line, from billing issues to compliance violations.

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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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MRO Compliance

AUGUST 3, 2022

By tracking and understanding audit activity, organizations can eliminate redundancy while filling in the gaps in revenue cycle compliance. Consider auditing software that can instantly transmit charts, discussions, and appeal filings to Medicare, Medicaid and commercial auditors, preventing file loss and delivery delay.

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Compliance Officers Medicare Medicare Compliance 130

MedTrainer

JULY 29, 2024

Healthcare compliance is complicated for organizations of any size. However, the complexities grow exponentially for large or enterprise organizations with hundreds or thousands of employees who must complete and pass rigorous compliance training. What Is Corporate Compliance Training?

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YouCompli

DECEMBER 19, 2023

Last month, the Office of Inspector General (OIG) published a new, user-friendly, 91-page General Compliance Program Guidance (GCPG). Exclusions (page 26) : OIG recommends that any entity participating in the federal Medicaid program should check the state Medicaid program exclusion list for each applicable state.

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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

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. Robust, flexible, and reliable compliance programs must be developed to maintain compliance in Hawaii.

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Compliancy Group

AUGUST 30, 2024

Ensuring compliance in your hospital, private practice, or healthcare company means safeguarding patient data, optimizing working conditions for employees, and promoting the highest quality of care. We suggest incorporating them into an annual compliance checklist for companies across the healthcare sector.

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MedTrainer

APRIL 20, 2023

That’s where compliance checklists come in. These helpful tools streamline your compliance systems and make it easier to ensure that your organization operates within the regulatory framework of your industry and specialty. Providers need a strong compliance program to inform the creation of compliance checklists.

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Compliancy Group

MARCH 22, 2024

As a compliance officer or critical decision-maker, you can help your healthcare organization avoid exclusion from this valuable program by creating a comprehensive compliance program and using software to streamline your compliance processes. Remaining in good standing with Medicare has several advantages.

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Verisys

MAY 3, 2023

7 Core Elements of Healthcare Compliance Plan and How to Measure Them Healthcare compliance regulations are complex and ever-changing, but are an essential part of any healthcare organization’s effort to provide safe, high-quality care for patients. What is an effective healthcare compliance program?

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MedTrainer

DECEMBER 4, 2023

Responsible healthcare providers and compliance professionals in each state of the United States must follow specific regulations, and achieving healthcare compliance in Kentucky is no exception. Regulations Unique to Kentucky To meet the standards of healthcare compliance in Kentucky , there are a few additional regulations.

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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.

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MedTrainer

APRIL 22, 2024

Several federal agencies highly recommend having a healthcare compliance committee — the key is to make the committee helpful, not just a regulatory checkbox. Compliance committees vary based on the size of the organization, the care setting, and the committee’s charter. What is a Healthcare Compliance Committee?

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MedTrainer

NOVEMBER 27, 2023

Managing healthcare compliance in Ohio presents a unique set of challenges for compliance officers, healthcare professionals, and administrators. Organizations need to successfully navigate the regulatory landscape in order to provide efficient and ethical healthcare services, and to avoid consequences for non-compliance.

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Health Care Performance

JULY 20, 2022

A New York ENT physician was convicted of filing false claims with Medicare and Medicaid. The physician submitted claims totaling about $585,000 to Medicare and Medicaid and was paid roughly $191,000. Compliance Lesson: Examples like this fall into the category of “truth is stranger than fiction.” That is how you collect $4.1

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MedTrainer

JULY 11, 2024

Maintaining regulatory compliance has never been easy, and the pace of change isn’t slowing. In this article, I will share the impact of change on regulatory compliance and a few strategies to reduce disruption. Let’s start by defining regulatory compliance. What Is Regulatory Compliance?

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C&M Health Law

DECEMBER 18, 2023

The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) published the General Compliance Program Guidance (GCPG) on November 6, 2023. The GCPG provides updated descriptions of the seven elements of an effective compliance program that health care entities have long relied upon.

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MedTrainer

NOVEMBER 30, 2023

Healthcare compliance in Missouri is uniquely challenging due to state-specific regulations, such as the surgical smoke plume evacuation system requirement. This article provides a concise overview of Missouri’s healthcare compliance, highlighting the state-specific requirements to be aware of.

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MedTrainer

DECEMBER 7, 2023

To sail smoothly through the complex rules and requirements, you need a deep knowledge of the most essential aspects of healthcare compliance in Maine. A successful compliance program involves adaptability, comprehensive planning, and insight into key compliance factors, including credentialing requirements.

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Verisys

APRIL 3, 2025

As a centralized hub of critical practitioner data, the NPDB serves as a powerful ally in provider credentialing , helping hospitals, medical boards, and institutions verify backgrounds, track malpractice claims, and ensure regulatory compliance. Medicare and Medicaid Compliance Requirements , which mandate reporting of program exclusions.

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MedTrainer

NOVEMBER 28, 2023

Healthcare providers, organizations, and compliance officers in Michigan State need to be aware of their state-specific laws and regulations in order to navigate compliance successfully. This article serves as a quick-reference guide for maintaining healthcare compliance in Michigan State.

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MedTrainer

SEPTEMBER 10, 2024

When talking about healthcare compliance education, these misunderstandings can have significant repercussions, from compliance gaps to inefficiencies in operations. Understanding common, but dangerous misconceptions about healthcare compliance education can potentially prevent your organization from these issues in the long run.

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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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