YouCompli

FEBRUARY 13, 2024

I recently attended the 2024 Health Care Compliance Association (HCCA) Managed Care Conference, and it was great to attend sessions and network with professionals and exhibitors from across the country. I can summarize these in three themes – the ABC’s, if you will, of integrating AI into your compliance strategy.

Compliance 52

Compliance Due Diligence Compliance Officers Governance 52

HIPAA Journal

MAY 26, 2023

In the healthcare industry, the term BAA compliance refers to a Business Associate complying with the terms of a Business Associate Agreement entered into with a Covered Entity. While, in theory, BAA compliance should be straightforward, this is not always the case – and sometimes, noncompliance is not the fault of the Business Associate.

Compliance 62

Compliance HIPAA Due Diligence 62

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 97

Compliance Compliance Officers Fraud HIPAA 97

Verisys

JULY 27, 2023

Achieving Transparency: How to Close A Critical Gap in Healthcare Compliance Continuous Data Monitoring is Key to Patient Safety Employing quality providers results in better patient outcomes. We use trusted data to protect your patients, ensure compliance, and speed up provider enrollment.

Compliance 52

Compliance Due Diligence Licensing Fraud 52

Compliancy Group

APRIL 29, 2022

One of the trendy marketing terms being used by equipment and service providers in the security space is “HIPAA Compliant Environment.” But security and compliance are not the same things. HIPAA Compliant Environment or a Culture of Compliance – Super Security Kryptonite. Compliancy Group can help! Learn More! ×

HIPAA 52

HIPAA Compliance Due Diligence Ransomware 52

Verisys

JULY 5, 2023

Achieving Transparency: How to Close a Critical Gap in Healthcare Compliance Continuous Data Monitoring is Key to Patient Safety Employing quality providers results in better patient outcomes. We use trusted data to protect your patients, ensure compliance, and speed up provider enrollment.

Compliance 52

Compliance Due Diligence Licensing Fraud 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

AIHC

JUNE 6, 2023

AI Use in Healthcare Research & Quality As posted in the American Institute of Healthcare Compliance (AIHC) June monthly newsletter, the Agency for Healthcare Research & Quality (AHRQ) grantee is testing AI for use to improve breast cancer screening accuracy and efficiency. Beware of new companies offering such services.

Compliance 59

Compliance Medical Billing HIPAA Due Diligence 59

AIHC

JUNE 6, 2023

AI Use in Healthcare Research & Quality As posted in the American Institute of Healthcare Compliance (AIHC) June monthly newsletter, the Agency for Healthcare Research & Quality (AHRQ) grantee is testing AI for use to improve breast cancer screening accuracy and efficiency. Beware of new companies offering such services.

Compliance 52

Compliance Medical Billing HIPAA Due Diligence 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

JANUARY 25, 2023

Healthcare organizations represented 19 percent of the 1,802 breaches reported in the 2022 ITRC report, with Financial Services (268), Manufacturing and Utilities (249), and Professional Services (224) following behind. Make Sure You’re HIPAA Compliant HIPAA compliance protects you against breaches. Find Out More!

HIPAA 119

HIPAA Electronic Medical Records Due Diligence Compliance 119

MRO Compliance

MAY 18, 2022

The Precision Medical Initiative, the 21st Century Cures Act, and the US Department of Health and Human Services Office for Civil Rights has contributed to the push for making PHI more accessible to patients. Organizations should provide formal training at least once a year to ensure compliance with applicable federal and state laws.

US Department of Health and Human Services 130

US Department of Health and Human Services Due Diligence Compliance COVID-19 130

Total Medical ComplianceHIPAA

JULY 6, 2023

Department of Health and Human Services, reached a $240,000 settlement with Yakima Valley Memorial Hospital following an investigation into a privacy breach. Vendor Due Diligence: Conduct thorough due diligence when selecting and working with vendors who have access to sensitive data.

Due Diligence 52

Due Diligence Hospitals Compliance HIPAA 52

Innovaare Compliance

FEBRUARY 5, 2024

Health Care Service Corporation (HCSC) has entered into a definitive agreement to purchase Cigna’s Medicare Advantage, Medicare Supplemental Benefits, Medicare Part D, and CareAllies businesses for $3.3 The sale allows Cigna to concentrate on its core business in employer-sponsored plans, which is expected to grow due to the U.S.

Medicare 52

Medicare Medicare Due Diligence Health Insurance 52

HIT Consultant

OCTOBER 17, 2022

Nathalie Feria, Manager at Kaufman Rossin’s Risk Advisory Services. Daniel Rosenberg, Manager at Kaufman Rossin’s Risk Advisory Services. Each business associate or vendor opens your organization to potential risk — and that risk increases as their access increases — so, do your due diligence. While the U.S.

Due Diligence 52

Due Diligence HIPAA Compliance Governance 52

HIPAA Journal

JUNE 20, 2023

There are many instant messaging platforms for mobile devices that allow rapid communication of information but they often lack the necessary privacy protections and security safeguards for communicating medical information to ensure global compliance. MSF was also impressed by Celo’s simple yet comprehensive interface and onboarding process.

Doctors 79

Doctors Due Diligence Telemedicine HIPAA 79

HIPAA Journal

APRIL 15, 2023

Nonetheless, businesses who operate in these industries – and service providers that do business with them – must understand what HIPAA compliance entails and how to become HIPAA compliant. What is HIPAA Compliance? Thereafter, follow the steps in the next section to become HIPAA compliant.

HIPAA 67

HIPAA Compliance Due Diligence Health Insurance 67

HIPAA Journal

DECEMBER 31, 2022

To best answer the question what is a HIPAA violation, it is necessary to explain what HIPAA is, who it applies to, and what constitutes a violation; for although most people believe they know what a HIPAA compliance violation is, evidence suggests otherwise. What is HIPAA and Who Does It Apply To? Other Types of HIPAA Law Violation.

HIPAA 132

HIPAA Due Diligence Compliance Fraud 132

Verisys

JULY 20, 2023

An organization must verify all certifications and licenses for every provider who administers patient services. 3: Allowing a physician to treat patients before credentialing is completed Courts have held hospitals liable when a physician falsifies credentials, and the hospital fails to do its due diligence in verifying them.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

YouCompli

NOVEMBER 15, 2023

Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) and the Federal Trade Commission (FTC) recently issued a warning regarding online tracking technologies. With the OCR and FTC focusing on these issues, compliance professionals should as well so they can best support their organization and their patients.

US Department of Health and Human Services 52

US Department of Health and Human Services HIPAA Compliance Due Diligence 52

Innovaare Compliance

FEBRUARY 5, 2024

Health Care Service Corporation (HCSC) has entered into a definitive agreement to purchase Cigna’s Medicare Advantage, Medicare Supplemental Benefits, Medicare Part D, and CareAllies businesses for $3.3 The sale allows Cigna to concentrate on its core business in employer-sponsored plans, which is expected to grow due to the U.S.

Medicare 40

Medicare Medicare Due Diligence Health Insurance 40

HIT Consultant

FEBRUARY 9, 2023

A lack of regulatory compliance, network and technical vulnerabilities, unencrypted information, unsecured mobile devices, and weak credentials all play a part in putting a healthcare organization at risk for a data breach. Paul Banco, CEO of etherFAX    How secure is your data? How Can a Data Breach Be Prevented?

Regulatory Compliance 52

Regulatory Compliance Due Diligence Compliance Compliance Framework 52

Hall Render

JANUARY 11, 2023

Department of Health & Human Services (“HHS”) updated the Mobile Health App Interactive Tool (the “Tool”) to include new questions and new use cases. For example, reimbursement under Medicare and Medicaid for certain telemedicine services was significantly increased due to the COVID-19 pandemic.

Compliance 40

Compliance HIPAA FDA Due Diligence 40

Compliancy Group

DECEMBER 7, 2023

Your first step to SOC 2 compliance is completing a SOC 2 readiness assessment. Change Management Assess how changes to your IT environment are documented, tested, and approved, ensuring they do not introduce vulnerabilities or disrupt services. What is a SOC 2 Gap Assessment?

Compliance 52

Compliance Due Diligence Compliance Framework Regulatory Compliance 52

Health Care Law Brief

JUNE 5, 2023

information or systems at risk by knowingly providing deficient cybersecurity products or services, knowingly misrepresenting their cybersecurity practices or protocols, or knowingly violating obligations to monitor and report cybersecurity incidents and breaches.” Jelly Bean’s failure left the website and such PHI vulnerable from attack.

Fraud 52

Fraud Due Diligence Medicaid Medicaid 52

YouCompli

MAY 24, 2023

Tips for Compliance Officers to Manage Risk A patient undergoes surgery requiring a medical device. Routine occurrences – and a potential compliance issue if it looks like financial kickbacks are involved. If the funds had been for legitimate consulting services, the anti-kickback statute would likely not have been implicated.

Compliance Officers 52

Compliance Officers Compliance Doctors Due Diligence 52

HIPAA Journal

JUNE 5, 2023

This is because, although most Microsoft business plans include the capabilities to support HIPAA compliance when using Teams, how the platform is used is what determines compliance. With Microsoft Teams, HIPAA compliance can also be reliant on which business plan an organization subscribes to.

HIPAA 63

HIPAA Due Diligence Compliance Licensing 63

Compliancy Group

JANUARY 24, 2022

You may feel the same way about HIPAA after scrolling through the thousand-plus related pages on the Health and Human Services website. It also defines how PHI must be managed by companies that provide services to covered entities ( business associates – BA). appeared first on Compliancy Group.

HIPAA 52

HIPAA Due Diligence Compliance Health Insurance 52

HIPAA Journal

JANUARY 21, 2024

A HIPAA Security Rule checklist helps covered entities, business associates, and other organizations subject to HIPAA compliance to fulfil the requirements of the Security Standards for the Protection of Electronic Protected Health Information (better known as the HIPAA Security Rule).

HIPAA 54

HIPAA Compliance Due Diligence Medicare 54

HIPAA Journal

MAY 29, 2023

It has been 27 years since President Clinton signed the Health Insurance Portability and Accountability Act (HIPAA) into law, but compliance is still proving a challenge for many HIPAA-regulated entities. The 2016-2017 HIPAA audit program identified many areas of noncompliance.

HIPAA 93

HIPAA Compliance Due Diligence COVID-19 93

MedTrainer

AUGUST 2, 2023

After that, the credentialing process is periodically reviewed and renewed to ensure ongoing compliance with standards and regulations. However, it’s important to remember how critical this process is for mitigating risk, improving compliance, and earning trust. Why Is Provider Credentialing Important?

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Total HIPAA

MAY 23, 2022

Therefore, understanding how to handle PHI is essential for achieving HIPAA compliance. Some companies sign a BAA without completing the HIPAA compliance process or ensuring that the other party has also done their due diligence. Most HIPAA rules and regulations revolve around protecting PHI. clean desk policy (CDP).

HIPAA 98

HIPAA Due Diligence Compliance Health Insurance 98

HIPAA Journal

MARCH 15, 2023

The company provides web hosting functions and services for its clients, one of which was the Florida Healthy Kids Corporation (FHKC). FHKC contracted with Jelly Bean Communications Design on October 13, 2013, to provide web design, programming, and hosting services.

Health Insurance 72

Health Insurance HIPAA Due Diligence Fraud 72

HIPAA Journal

OCTOBER 21, 2022

According to the Privacy Rule, PHI has to be disclosed when an individual requests access to it or when HHS´ Office for Civil Rights is conducting an audit, an investigation, or a compliance review. Disclosures for the twelve public interest and benefit activities listed in 164.512 – subject to compliance with the Minimum Necessary Standard.

HIPAA 71

HIPAA Due Diligence Compliance Licensing 71

Health Law RX

AUGUST 10, 2021

The whistleblowers’ qui tam complaints alleged that Alliance violated the AKS by providing EEG interpretive reports to non-neurologist physicians who referred patients to Alliance to enable them to bill government healthcare programs for services they did not provide. Moreover, the U.S.

Due Diligence 40

Due Diligence Compliance Governance Fraud 40

Verisys

NOVEMBER 30, 2023

Credentialing mistakes lead to financial losses on provider services, delays in claim reimbursements, fines or penalties, exclusion from federally funded programs, and harm to patients. All certifications and licenses must be verified for every provider who administers services to patients. Mistake No. Mistake No.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

MedTrainer

AUGUST 2, 2023

It’s why many healthcare organizations use credentialing software or credentialing services to expedite the process. 5 Tips: How to Select a Credentialing Service With so many roadblocks and potential delays, a credentialing service or software is often a wise investment.

Due Diligence 52

Due Diligence Malpractice Licensing Compliance 52