MedTrainer

JANUARY 10, 2024

It may seem a little early to do some spring cleaning, but not when it comes to compliance! It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. Release of Industry-Specific Compliance Program Guidance (ICPG) is anticipated in 2024.

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Compliance Fraud HIPAA Compliance Officers 94

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.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

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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Medicaid Medicaid Compliance Overpayments 52

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.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

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.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

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).

Compliance 52

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

Compliance 52

Compliance Compliance Officers Licensing Medicaid 52

MedTrainer

MARCH 28, 2024

Healthcare compliance. Just as perplexing is who is responsible for compliance in healthcare organizations. The answer has as many layers as the definition of compliance itself. The answer has as many layers as the definition of compliance itself. Who in the Organization Is Responsible for Healthcare Compliance?

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 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.

Compliance 52

Compliance Compliance Officers Licensing Medicaid 52

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 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

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MARCH 22, 2024

Today’s healthcare workers expect more from a compliance training program. For the administrators, compliance officers, and HR professionals tasked with crafting such programs, the challenge is finding a balance between what is legally required and what is practical for their already stretched staff.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

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.

Compliance 52

Compliance Compliance Officers Governance Overpayments 52

MedTrainer

JANUARY 30, 2024

What types of healthcare facilities are required by the government to have a compliance program? In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them.

Governance 52

Governance Compliance Nursing Homes Medicaid 52

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.

Compliance 52

Compliance Compliance Officers Hospitals Public Health 52

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.

Compliance 52

Compliance Licensing Compliance Officers Medicaid 52

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.

Compliance 52

Compliance Licensing Public Health Compliance Officers 52

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.

Compliance 52

Compliance Compliance Officers Regulatory Compliance Regulations Compliance 52

MedTrainer

OCTOBER 23, 2023

In today’s intricate healthcare landscape, compliance can mean a lot of different things, which might leave you wondering, “What is healthcare compliance?” At its core, healthcare compliance is adherence to the vast array of regulatory and procedural standards that protect patients and ensure the highest standard of care.

Compliance 52

Compliance Compliance Officers Fraud Governance 52

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?

Compliance 52

Compliance Compliance Officers ADA Governance 52

Healthicity

JUNE 23, 2022

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

Compliance Officers 98

Compliance Officers Medicaid Medicaid Medicare 98

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?

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 52

Compliancy Group

FEBRUARY 2, 2024

Regarding compliance in the healthcare field, a practice, doctor’s office, or healthcare organization is constantly in the spotlight. A Department of Justice (DOJ) evaluation of a corporate compliance program involves an examination of its effectiveness in preventing and detecting instances of noncompliance.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

MedTrainer

NOVEMBER 30, 2023

To manage healthcare compliance in Alabama successfully, providers and compliance officers need to know the ins-and-outs of state-specific regulations. While tricky to navigate, staying up to date with compliance requirements and standards can make the process more manageable.

Compliance 52

Compliance Compliance Officers Public Health Licensing 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.

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Compliance Compliance Officers Fraud Compliance Framework 52

MedTrainer

NOVEMBER 30, 2023

Like other regions in the United States, Wisconsin is characterized by its unique blend of rules and mandates that govern healthcare compliance within the state. This post sheds light on certain aspects of healthcare compliance in Wisconsin, with tips for effectively managing your healthcare organization.

Compliance 52

Compliance Medicaid Medicaid Licensing 52

MedTrainer

FEBRUARY 12, 2024

Knowingly or falsely claiming monies from federal programs such as Medicare and Medicaid has cost healthcare entities $72B since 1986. How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims?

Compliance 52

Compliance Fraud Medicaid Medicaid 52

MedTrainer

JANUARY 12, 2024

Healthcare compliance is serious business for regulators. In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. What is Healthcare Compliance? Who Regulates Healthcare Compliance?

Compliance 52

Compliance Fraud Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

What does healthcare compliance in Georgia look like? Like all states, Georgia has its own distinct rules and regulations that compliance management teams must follow. Keep reading for resources, tips, and regulations unique to healthcare compliance in Georgia. These requirements are unique to Georgia.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

As is the case with every state, there are distinctive challenges in the management of healthcare compliance in North Carolina, shaped by its own unique regulations. Keep scrolling for a summary of the crucial elements of healthcare compliance relevant to North Carolina.

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

MedTrainer

JANUARY 12, 2024

At its core, healthcare compliance ensures the quality of care, patient safety, and integrity of healthcare systems. Over the years, healthcare compliance has evolved significantly, driven by changing regulations, advances in technology, and a growing emphasis on patient-centric care. What is Healthcare Compliance?

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Compliance HIPAA Telemedicine ACA 52

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. Findings from OIG audits can identify compliance areas needing improvement.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

MedTrainer

NOVEMBER 29, 2023

With its distinctive legal environment, Louisiana poses a few unique healthcare compliance challenges that differ from other states. Managing healthcare compliance in Louisiana successfully means that providers and organizations can skillfully navigate their state-specific regulatory framework.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 17, 2023

Managing healthcare compliance in Illinois requires healthcare organizations and professionals to stay informed about state-specific regulations while also adhering to federal healthcare compliance standards. Medical licensing is provided by the Illinois Department of Financial and Professional Regulation.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

Healthcare compliance in New Mexico mirrors the state’s diverse culture, with unique regulations that differ from other states, such as credentialing documentation requirements for managed care organizations. New Mexico’s parity law requires insurers to cover telemedicine services to the same extent as in-person services.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

JANUARY 26, 2024

Non-compliance in healthcare refers to the failure of healthcare providers, institutions, or individuals to adhere to the laws, regulations, and standards established to protect patient welfare, maintain data security, and ensure the efficient and ethical delivery of healthcare services. What is Healthcare Compliance?

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