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The Cobra Effect & Enforcing Compliance Standards

AIHC

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

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HHS is prioritizing consumer experience, data exchange, explainable AI

Healthcare It News

"We serve the same families in our Administration for Children and Families that we serve with Medicare and Medicaid, that we serve in our Substance Abuse and Mental Health Services Administration," said Palm. "If you've seen one Medicaid program, you've seen one Medicaid program.

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How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

What the HHS-OIG says about vendor compliance. chief executive officer, chief financial officer, general counsel, director of health information management, director of human resources, physician practice office manager, etc.) at a provider that furnishes items or services payable by Federal health care programs. Case Study: S.

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July Regulatory Update

Verisys

July Regulatory Update – The best resource for monthly updates. A big thanks to our compliance team, who monitors state, federal, and international updates. Major changes to Medicaid credentialing are effective July 1, 2024. Here is our monthly regulatory update. The majority of the bill is effective July 1, 2023.

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Key Plastic Surgery Coding Tips for Accurate Reimbursement

Medisys Compliance

Numerous resources are available to assist with CPT coding. The American Society of Plastic Surgeons (ASPS) offers a comprehensive coding guidebook, and online resources provide up-to-date coding information and tips. Modifier codes and their definitions may change over time.

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Proper Payments for Part B and Part D Drugs

Innovaare Compliance

Until the enactment of the Medicare Modernization Act (MMA) in 2006 [1] , the Centers for Medicare & Medicaid Services does not cover most outpatient prescription drugs under Part B (“Part B drugs”). Plan sponsors should be very clear about the definition of a Part D drug, which excludes any drugs covered under Part A (e.g.,

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Understanding Modifiers for Mental Health Billing

Medisys Compliance

This article aims to provide a comprehensive guide to modifiers for mental health billing, exploring their definitions, purposes, and relevant keywords. Compliance promotes consistency and accuracy in mental health billing practices. What are Modifiers?