Compliancy Group

JANUARY 3, 2024

One of the most common ways for providers and healthcare organizations to run afoul is to incorrectly or illegally bill and code for services or supplies. This article discusses the issues related to medical billing compliance policy and the steps for providers to maintain financial integrity and adherence to all requirements.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 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

HIT Consultant

APRIL 29, 2024

Expanded Breach Definition: The rule now encompasses unauthorized access or disclosure of identifiable health information, providing broader protection for consumers. Improved Readability: The revised rule simplifies language for better comprehension and promotes compliance.

Health Insurance 128

Health Insurance HIPAA Compliance 128

YouCompli

MARCH 22, 2023

The second type is typically called quantitative or definitive drug testing. 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%.

Overpayments 52

Overpayments Overpayment Compliance Medicare 52

HIPAA Journal

NOVEMBER 17, 2022

HIPAA Journal is conducting interviews with healthcare professionals and service providers to find out more about their compliance journeys, how the HIPAA Rules have affected their working lives, and the successes and challenges they have faced with HIPAA compliance. My professional goals changed over time.

Governance 83

Governance HIPAA Compliance Nursing Homes 83

Healthcare IT Today

MAY 31, 2022

NYSE American: CTEK), a leading cybersecurity, privacy, compliance, and IT audit firm helping organizations in highly regulated industries navigate emerging security and privacy issues, announces it has entered into a definitive agreement to be acquired by Clearwater Compliance LLC (collectively with its affiliates, “Clearwater”), […].

Compliance 54

Compliance 54

YouCompli

DECEMBER 19, 2023

Last month, the Office of Inspector General (OIG) published a new, user-friendly, 91-page General Compliance Program Guidance (GCPG). Users are encouraged to use the electronic version, to allow access to hyperlinked definitions and resource documents.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

YouCompli

JANUARY 16, 2024

A simple and effective approach is to survey key stakeholders by asking, “ How has the compliance team been most effective and valuable to you ?” There are three areas that support moving from a reactive to a proactive compliance program. Does the corporation’s compliance program work in practice?

Compliance 52

Compliance Compliance Officers Hospitals 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

YouCompli

JULY 12, 2023

Mock audits deliver value for healthcare   Mock audits are an incredible tool for compliance officers to protect a healthcare organization’s revenue and add tangible value. They are time consuming, but they can dramatically advance your compliance program. How do we capture revenue?

Compliance 52

Compliance Compliance Officers Hospitals 52

YouCompli

SEPTEMBER 6, 2023

It definitely wasn’t in any of mine! But very quickly, as a compliance officer, I realized that I was managing multiple projects every day. Conducting annual compliance training is a project.   This would likely entail performing tracers on a sample of enrolled subjects and/or services.

Compliance 52

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

HIPAA Journal

APRIL 29, 2024

In the event of a breach of covered data at a third party that provides services to vendors of PHRs or PHR-related entities, they are required to notify the PHR vendor or PHR-related entity in the event of a breach. The Federal Trade Commission (FTC) issued a final rule on April 26, 2024, that updates the FTC Health Breach Notification Rule.

HIPAA 89

HIPAA Health Insurance Compliance 89

Healthcare IT News - Telehealth

JUNE 9, 2022

Smart phones, wearable devices, telemedicine platforms, artificial intelligence software, internet applications, and other digital health technologies are advancing and transforming disease diagnosis, therapy, and other medical practices by physicians, direct-to-consumer services for better health and well-being, and other healthcare services.

Licensing 157

Licensing Telemedicine Governance Compliance 157

Healthcare IT Today

DECEMBER 14, 2022

Today, we’re featuring the Senior Technical Analyst, Delivery Services position that was recently posted on Healthcare IT Central. This position was posted by TransForm Shared Service Organization and is located in Windsor, Canada. to address and improve service delivery quality. Must be local and available for on-call.

Compliance 99

Compliance Hospitals 99

YouCompli

OCTOBER 26, 2022

Helping our clinical colleagues feel the urgency of compliance monitoring can be a huge challenge. And the Compliance team simply doesn’t have the clinical expertise to own the monitoring of these requirements. The auditor found an LCD that addressed polysomnography services. Don’t let processes overwhelm clinical colleagues.

Compliance 52

Compliance Compliance Officers Overpayments Overpayment 52

Provider Trust

MAY 17, 2022

So what does that mean for your healthcare organization’s compliance program? Is your organization properly vetting and monitoring compliance of your entire vendor network? The answer is simple – a healthcare vendor is defined as any entity or individual that is paid by a healthcare organization for goods or services.

Compliance 52

Compliance Medicare Medicare Due Diligence 52

YouCompli

NOVEMBER 9, 2022

Compliant Billing for Critical Care Evaluation and Management Services. This month’s article looks at critical care services. These codes are reimbursed at a higher rate than the typical evaluation and management, (E/M) codes reported for less-intensive professional medical services. CJ Wolf, MD ?provides

Compliance 52

Compliance Medicare Medicare Hospitals 52

American Medical Compliance

APRIL 23, 2024

American Medical Compliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education to physicians. American Medical Compliance designates this activity for a maximum of 1.25 To become certified, please visit us at: American Medical Compliance (AMC).

Compliance 52

Compliance Public Health 52

HIPAA Journal

SEPTEMBER 5, 2023

The EU Digital Services Act is due to come into force for most “intermediary” service providers that offer a service to EU citizens from February 17, 2024. The Digital Services Act is a new EU law that updates the existing EU Electronic Commerce Directive.

Compliance 55

Compliance HIPAA Governance Fraud 55

YouCompli

APRIL 12, 2023

Incentives, Compensation Structures, and Consequence Management for Healthcare Compliance A new document from the Department of Justice (DOJ) will give you reason to revisit some of your healthcare compliance benchmarks. These steps are an effort to elevate the level of compliance effectiveness.

Compliance 52

Compliance Compliance Officers Hospitals 52

Medisys Compliance

AUGUST 23, 2022

Managing this challenging revenue cycle issues by outsourcing medical billing services works out to be a great option for many providers. Absence of professional oversight for medical billing services may have an impact on cash flow, which would hamper the overall revenue generation.

Medical Billing Services 97

Medical Billing Services Medical Billing Medical Billing Outsourcing 97

American Medical Compliance

FEBRUARY 27, 2023

OSHA Training for Emergency Medical Services (EMS) will educate emergency medical workers on how to protect themselves and others while adhering to State and Federal OSHA regulations. There are several different elements to OSHA compliance. To become certified, please visit us at American Medical Compliance (AMC).

Compliance 52

Compliance Hospitals 52

Total HIPAA

FEBRUARY 23, 2023

Definition of HIPAA Breaches A simple oversight or event may qualify as a HIPAA breach. Here are a few examples from the HHS website: A municipal social service agency disclosed PHI while processing Medicaid applications. You must train your employees on this process so they can help your organization maintain HIPAA compliance.

US Department of Health and Human Services 52

US Department of Health and Human Services HIPAA Compliance Medicaid 52

Provider Trust

AUGUST 10, 2022

Ronette Adams-Taylor has been the Associate General Counsel and Director of Compliance and Risk Management for Meharry Medical College for the last 10 years. Q: In the healthcare industry, why is compliance monitoring important? Q: How is Meharry utilizing ProviderTrust’s products/services? We are a small team.

Compliance 52

Compliance Governance 52

Provider Trust

MAY 18, 2022

All companies rely on third parties, independent contractors, suppliers and other key partners in order to effectively perform their services. What the HHS-OIG says about vendor compliance. at a provider that furnishes items or services payable by Federal health care programs. But how well do you know your vendors?

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

Compliancy Group

AUGUST 3, 2022

Procurement compliance and security are often put on the back burner when companies try to save money. Cisco said, “We are committed to maintaining the integrity and quality of Cisco products and services. ” Let’s Simplify Compliance HIPAA and device security go hand-in-hand. × HIPAA Compliance Simplified.

Compliance 52

Compliance HIPAA Licensing Governance 52

YouCompli

MARCH 15, 2023

Project Management Methodologies for Healthcare Compliance Sharon Parsley, JD, MBA, CHC, CHRC contributes a regular post on compliance officer effectiveness for the YouCompli blog. It definitely wasn’t in any of mine! It definitely wasn’t in any of mine! Conducting annual compliance training is a project.

Compliance 40

Compliance Compliance Officers Medicare Medicare 40

Healthcare It News

SEPTEMBER 21, 2021

Although the law does not apply to nonprofits, "given the law’s broad definition of 'business' and 'consumer,' companies across the U.S. The high cost of compliance without an equitable ROI. Part of the issue, say researchers, stems from the combination of CCPA and HIPAA. THE LARGER TREND.

HIPAA 288

HIPAA COVID-19 Regulatory Compliance Compliance 288

Medisys Compliance

JANUARY 4, 2024

This article equips primary care providers with the latest knowledge and technical expertise to navigate the process seamlessly, maximizing new patient visit billing accuracy and minimizing compliance risks. However, specific definitions might differ depending on payers and specialties.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 59

Healthcare Law Today

NOVEMBER 16, 2022

Companies whose business models are based entirely on remote provision of services face a number of unique employment law challenges. Changes to these various definitions of independent contractor are percolating throughout the different branches of government. Another Hot Ongoing Compliance Issue: Expense Reimbursement.

Regulations Compliance 52

Regulations Compliance Compliance Licensing Nurses 52

Healthcare Law Blog

FEBRUARY 28, 2023

On February 13, 2023, the Centers for Medicare and Medicaid Services (CMS) published the revised List of Telehealth Services for Calendar Year (CY) 2023 (List). The List includes the services that are payable under the Medicare Physician Fee Schedule when furnished via telehealth.

Medicare 52

Medicare Medicare Nurses Licensing 52

Healthcare Law Blog

NOVEMBER 2, 2023

population size of those 65 years and older continues to increase, the demand for long-term services and supports (“LTSS”) is also expected to increase. [1] 1] LTSS represents the wide-ranging health and social services that individuals require over an extended period of time, including assistive services. [2]

Nursing Homes 52

Nursing Homes Medicaid Medicaid Medicare 52

Compliancy Group

APRIL 26, 2024

Wade, the Department of Health and Human Services’ Office for Civil Rights issued a Notice of Proposed Rulemaking to modify the HIPAA Privacy Rule in April of last year. The Final Rule modifies the existing Privacy Rule by changing the definition of the term “person.” Jackson Women’s Health Organization , which overruled Roe v.

HIPAA 59

HIPAA Compliance Health Insurance Public Health 59

HIPAA Journal

JULY 19, 2023

HIPAA compliance laws set the standards for protecting sensitive patient data that healthcare providers, insurance companies, and other covered entities must adhere to. You can use our HIPAA Law Compliance Checklist to check your compliance requirements and avoid HIPAA violations.

HIPAA 92

HIPAA Compliance 92

Innovaare Compliance

OCTOBER 6, 2022

According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising. MAOs have to ensure that TPMOs use a standardized disclaimer in their marketing materials that meet the definition of marketing whether they are in print, on the website, or in television advertising.

Medicare 52

Medicare Medicare Compliance Public Health 52

Healthcare IT Today

JUNE 6, 2023

When applying this definition to your revenue cycle operations, having revenue integrity means that your healthcare organization is receiving optimal return for every clinical encounter by being operationally efficient, assuring appropriate reimbursement, and remaining compliant with regulatory requirements.

Compliance 54

Compliance 54

HIT Consultant

APRIL 8, 2024

What You Should Know: – Model N (NYSE: MODN), a leading provider of revenue optimization and compliance solutions for the life sciences and high-tech industries, has announced a definitive agreement to be acquired by Vista Equity Partners (“Vista”). per share in an all-cash transaction valued at approximately $1.25

Compliance 52

Compliance 52