AIHC

SEPTEMBER 3, 2024

Celebrating the Healthcare Compliance Officer The American Institute of Healthcare Compliance is recognizing healthcare Compliance Officers – hats off to you! The primary goal of a compliance officer is to mitigate risk. Compliance is a complex and difficult job!

Compliance Officers 52

Compliance Officers Compliance Fraud Medicare 52

MedTrainer

AUGUST 8, 2024

As of March 2024, over 67 million in the United States are Medicare beneficiaries. Medicare is the single largest payer for healthcare services in the United States. In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Here’s what you need to know.

Medicare 93

Medicare Medicare Compliance Medicaid 93

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. Legal Consequences for Violating Stark Laws in Healthcare The Office of Inspector General (OIG), through the U.S.

Compliance Officers 59

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

AIHC

NOVEMBER 12, 2024

6] The letter also notes that obtaining informed consent for sensitive examinations is the standard of care and that OCR will continue to focus on provider compliance with HIPAA and proper informed consent. About the Author Gabriella Neff , RHIA, CHA, CHC, CHRC, CHPC is a Research Compliance Officer for H.

Informed Consent 98

Informed Consent HIPAA Compliance Hospitals 98

HIPAA Journal

MARCH 30, 2023

The seven elements of a compliance program are integrated processes organizations in all industries can adopt to help them develop a culture of compliance in the workplace. While the seven elements of a compliance program apply to all industries, they originated in the healthcare industry in the 1990s.

Compliance 111

Compliance Compliance Officers Fraud HIPAA 111

Compliancy Group

OCTOBER 4, 2024

Despite your best efforts in meeting healthcare compliance requirements, errors may still occur. We also discuss how compliance software can help ensure regulatory compliance and maximize efficiency and accuracy in all your compliance activities. What is an Audit in Healthcare?

Compliance Officers 59

Compliance Officers Compliance Regulatory Compliance Fraud 59

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.

Compliance Officers 52

Compliance Officers Compliance Medicaid Medicaid 52

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.

Compliance Officers 52

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

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?

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

Health Law RX

NOVEMBER 22, 2023

Department of Health and Human Services (the OIG) recently released an updated General Compliance Program Guidance document (GCPG). The GCPG discusses general compliance risks and compliance considerations. The GCPG discusses general compliance risks and compliance considerations. Other Compliance Considerations.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 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

YouCompli

JANUARY 4, 2023

The healthcare enterprise risk approach takes compliance in new directions . Featured speakers: James Bryant , Vice President and Chief Compliance Officer, Brigham and Women’s Hospital; Timothy C. They spoke about going beyond historical healthcare compliance duties like billing coding to include.

Compliance Officers 52

Compliance Officers Compliance ADA Hospitals 52

HIPAA Journal

DECEMBER 28, 2022

Discussing HIPAA compliance for hospitals in a single article is challenging. This means there is no one-size-fits-all guide to HIPAA compliance for hospitals, but rather checklists that can help hospitals cover the basics of the compliance requirements. The Five Areas of HIPAA Compliance for Hospitals to Focus On.

HIPAA 91

HIPAA Compliance Hospitals Medicare 91

Compliancy Group

MARCH 22, 2024

depend on Medicare to get the healthcare they need. Remaining in good standing with Medicare has several advantages. Compliance Program A comprehensive way to avoid Medicare exclusion is to develop an organization-wide compliance program, one of the Centers for Medicare and Medicaid Services (CMS) requirements.

Medicare 52

Medicare Medicare Compliance Compliance Officers 52

MedTrainer

MAY 3, 2024

Non-compliance with these regulations can result in jail time, large fines, and even loss of license. Keeping compliance and fraud prevention top of mind can help to protect both your organization and its staff. For those who are not, there are five main federal laws they are likely violating related to healthcare fraud.

Fraud 94

Fraud Compliance Compliance Officers Licensing 94

YouCompli

NOVEMBER 18, 2023

In this article, we will examine four essential listening skills that help compliance officers be more effective within their organizations. Others were about privacy or another compliance matter. Sharon Parsley, JD, MBA, CHC, CHRC, is a health law attorney, compliance officer, author, speaker, investigator, and problem solver.

Compliance Officers 52

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

Compliancy Group

DECEMBER 25, 2024

Credentialing also ensures that all employees know the rules for filing Medicare claims and using the proper billing codes. Credentialing software can help you automate the tracking of your staff while navigating the complexities of healthcare compliance laws. What’s the Purpose of Credentialing Software?

Compliance 52

Compliance Compliance Officers Licensing Doctors 52

Compliancy Group

MARCH 12, 2025

A healthcare organization that does not follow proper methods of obtaining reimbursement from federal payor programs such as Medicare may run afoul of federal fraud, waste, and abuse laws. To avoid running afoul of potential civil or criminal liability, organizations must ensure that Medicare claim reporting is accurate.

Fraud 52

Fraud Compliance Medicare Medicare 52

Compliancy Group

APRIL 23, 2024

Compliance in all healthcare settings requires an in-depth understanding of the standards that the U.S. Office of Inspector General (OIG) enforces. However, OIG corporate compliance oversight is typically more rigorous, often resulting in more severe consequences for violations. Minimizing their importance can be costly.

Compliance 59

Compliance Compliance Officers Regulatory Compliance Medicare 59

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.

Compliance Officers 130

Compliance Officers Medicare Medicare Compliance 130

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?

Compliance 52

Compliance Compliance Officers Health Insurance Medicaid 52

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

Compliancy Group

OCTOBER 16, 2024

There’s a significant connection between healthcare compliance and risk management. Compliance officers must thoroughly understand both concepts to protect their organizations and the patients they serve. Risk management refers to identifying, avoiding, and mitigating the factors contributing to healthcare non-compliance.

Compliance 52

Compliance Compliance Officers Fraud Regulatory Compliance 52

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.

Licensing 52

Licensing Compliance Nurses Malpractice 52

Compliancy Group

JUNE 21, 2024

The Office of the Inspector General (OIG) has honed in on chiropractic practices over the last few years because of improper payments and claims, and noncompliance with Medicare requirements. There seems to be a gap between chiropractic services and positive compliance outcomes.

Compliance 52

Compliance Compliance Officers Medicare Medicare 52

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.

Compliance 52

Compliance Licensing Doctors Malpractice 52

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).

Compliance 52

Compliance Compliance Officers Fraud Medicaid 52

Compliancy Group

SEPTEMBER 16, 2024

Office of Inspector General (OIG) enforces the General Compliance Program Guidance. In November, updates for 2024 appeared in the OIG General Compliance Program Guidance, including recommendations for Medicare, nursing facilities, and other industry-specific entities.

Compliance 52

Compliance Compliance Officers Fraud Electronic Medical Records 52

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?

Compliance 52

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

Healthcare Law Blog

NOVEMBER 9, 2023

In late April this year, the Office of Inspector General, Department of Health and Human Services (OIG) announced that it would make changes to its existing body of healthcare compliance program guidance (CPGs) as part of its current Modernization Initiative. [1] On November 6, 2023, OIG finally published the GCPG on its website [3].

Compliance 52

Compliance Compliance Officers Fraud Medicare 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

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

YouCompli

JANUARY 4, 2022

Featured speakers: Craig Bennett , Vice President and Chief Compliance Officer, Boston Medical Center; Rachel Lerner , Esq., Bennett, Lerner and Palumbo addressed the Massachusetts Health and Hospital Association’s Healthcare Legal Compliance Forum in December 2021. Building a culture of compliance. New compliance issues.

Compliance Officers 40

Compliance Officers Public Health Compliance COVID-19 40

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.

Compliance 52

Compliance Fraud Compliance Officers HIPAA 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

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?

Compliance 52

Compliance Compliance Officers Governance Medicaid 52

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. Fraudulent documentation was submitted in response to Medicare audits. How well is your compliance program performing?

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Fraud Compliance Medicaid Medicaid 52