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Healthcare Compliance Risks with Urine Drug Testing Overpayments 

YouCompli

There has been significant enforcement over the last couple years relating to overpayments for UDT. Department of Health and Human Services Office of Inspector General (OIG) has expressed concerns about UDT billing. The overpayment rate for definitive drug testing for 22 or more drug classes was over 71%.

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New York State OMIG Makes Regulatory Modifications to Compliance Program Requirements

Health Law Advisor

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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OIG Issues Updated General Compliance Program Guidance: Overview of Key Elements & Changes

C&M Health Law

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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Avoiding “Gotcha” Moments in Compliance 

YouCompli

As compliance officers, we are continually placed in a position to influence the actions of others and help shape our organization’s compliance culture. One way to change that perception is to avoid creating “gotcha” moments when you’re working on a compliance-related matter. Here are four tips that will help.

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Department of Justice (DOJ) Evaluation of Corporate Compliance Programs

Compliancy Group

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.

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Patient-Focused Elements of an Effective Healthcare Compliance Program

YouCompli

Using the OIG’s seven elements as a guide to delivering better patient care Healthcare Compliance professionals tend to focus, rightfully so, on the regulations and organization requirements around providing quality patient care and keeping patients safe. Compliance officers have three main roles in this.

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Attention New York Medicaid Providers: It’s Time to Upgrade Your Compliance Program

Healthcare Law Blog

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]