MedTrainer

JANUARY 26, 2024

The best way to maintain these standards is by providing healthcare compliance training for all staff members. Even when training is not required, it may still be very beneficial for your staff and overall organizational compliance. What topics should be covered in healthcare compliance training?

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Compliancy Group

NOVEMBER 28, 2023

With countless lives at stake every day, it becomes crucial to establish effective compliance programs in healthcare organizations. We will delve into the world of compliance programs in healthcare and explore their numerous benefits. What Are Compliance Programs in Healthcare?

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MedTrainer

OCTOBER 4, 2023

To ensure organizations meet these standards, federal healthcare compliance requirements have been put in place. These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. What Are Federal Healthcare Compliance Requirements?

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Compliance Fraud HIPAA Governance 52

Medisys Compliance

NOVEMBER 6, 2023

Introduction Orthopedic billing compliance is essential for healthcare providers to avoid costly audits and penalties. By following a comprehensive orthopedic billing compliance checklist, providers can ensure that their claims are accurate, complete, and supported by proper documentation.

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Compliance Medical Billing Outsourcing Medical Billing ACA 59

YouCompli

DECEMBER 11, 2023

The long-awaited, new OIG General Compliance Program Guidance (GCPG) has been released, all 91 pages of it. If you have not viewed it yet, click here: [link] This release is the first major compliance guidance document the OIG has shared in many years. The compliance officer should either report directly to the CEO or the Board.

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Compliance Compliance Officers Fraud HIPAA 52

Compliancy Group

AUGUST 17, 2023

This responsibility falls on the shoulders of healthcare compliance managers, professionals who play a vital role in ensuring that healthcare organizations operate within legal boundaries and maintain the highest standards of integrity. Rated #1 on G2 “Compliancy Group makes a highly complex process easy to understand.” Please Wait.

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MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

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Compliance Framework Governance Compliance Medicaid 52

AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

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Compliance Fraud Medicare Medicare 52

Compliancy Group

AUGUST 2, 2023

As the healthcare industry grows and changes, organizations face increasing challenges regarding compliance and risk management. Healthcare GRC (Governance, Risk, and Compliance) is a crucial framework that helps healthcare providers navigate these complexities effectively. Please Wait.

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Compliance Regulatory Compliance Governance Fraud 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?

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Compliance Compliance Officers ADA Governance 52

Compliancy Group

FEBRUARY 7, 2024

CMS UPIC audits are designed to identify and prevent fraud, waste, and abuse within Medicare and Medicaid, ensuring that federal funds are used appropriately and that the services billed for are actually provided and are medically necessary. Given their significant impact, healthcare organizations must take UPIC audits seriously.

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Fraud Compliance Medicare Medicare 52

Compliancy Group

AUGUST 23, 2023

In a shocking turn of events, a dental office manager from Worcester has been sentenced for participating in a scheme to defraud the Massachusetts Medicaid program, MassHealth. Prosecutors Evan Panich and Chris Looney from the Health Care Fraud Unit, alongside Special Assistant U.S. Senior District Court Judge Timothy S.

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Fraud Medicaid Medicaid Governance 52

Innovaare Compliance

MAY 26, 2022

On April 15, 2022, the Centers for Medicare & Medicaid Services (CMS) released potential fraud, waste and abuse (FWA) trending data collected from Medicare Advantage Prescription Drug Plans (plan sponsors) for fourth quarter 2021. The post CMS Reminder of Medicare Fraud, Waste and Abuse Vigilance appeared first on Inovaare.

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HIT Consultant

JANUARY 3, 2023

But they have also expanded the attack surface at these organizations and increased the level of risk and vulnerabilities that could result in direct loss of proprietary information, direct financial damage including theft and fraud, and potential loss of life (in addition to regulatory fines and brand damage) the healthcare sector faces.

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Compliance Ransomware Fraud Regulatory Compliance 52

Total HIPAA

DECEMBER 13, 2021

In the event of a breach, a company that has complied with the DPA can assert DPA compliance as a defense to any claim that may come up. How does this relate to HIPAA compliance? So, if your organization is one that is required to adhere to sector-specific laws, HIPAA compliance may be part of DPA compliance as well.

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HIPAA Compliance Fraud Health Insurance 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.

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Compliance Medical Billing HIPAA Due Diligence 59

HIPAA Journal

JANUARY 30, 2023

The National HIPAA Summit is the leading forum on healthcare EDI, privacy, breach notification, confidentiality, data security, and HIPAA compliance, and the deadline for registration for the Virtual 40th National HIPAA Summit is fast approaching.

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US Department of Health and Human Services HIPAA Compliance Medicaid 81

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.

Compliance 52

Compliance Medical Billing HIPAA Due Diligence 52

Healthcare Compliance Blog

APRIL 26, 2022

The compliance documents include special fraud alerts, advisory bulletins, podcasts, videos, brochures, and papers providing guidance on compliance with federal healthcare program standards. Toolkits: The OIG has created several toolkits to help providers ensure they are in compliance with healthcare laws.

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US Department of Health and Human Services Fraud Compliance Medicaid 59

American Medical Compliance

JANUARY 9, 2024

Get Certified American Medical Compliance (AMC) is a leader in the industry for compliance, Billing, and HR solutions. To become certified, please visit us at: American Medical Compliance (AMC). This type of theft is just one example of healthcare fraud. Reach out for other courses by visiting the AMC Course Library.

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Fraud Medicare Medicare Compliance 52

Compliancy Group

FEBRUARY 29, 2024

By examining the purpose and regulatory mechanisms of these agreements, we can understand their role in ensuring compliance, promoting ethical conduct, and ensuring patient and employee safety. When a hospital, doctor’s office, or other healthcare organization is guilty of a regulatory or compliance violation , the U.S.

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Compliance Compliance Officers Overpayments Overpayment 52

Verisys

FEBRUARY 7, 2024

Checking staff for exclusions, sanctions, and adverse events. Preventing fraud by verifying the credentials of scientists, speakers, sales representatives, and research and clinical trial participants. Implementing effective compliance strategies Now let’s dig into each one and what organizations can do to stay compliant.

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Compliance Licensing Compliance Framework Fraud 52

Healthcare Law Today

FEBRUARY 3, 2023

To learn more and register for the event, visit the ATA2023 conference website. Use code ATA23FOLEY50 for a 50% discount. Be sure to stop by Booth 1302 in the Expo Hall to meet and reconnect with your Foley contacts. ATA 2023: Join Us for Live Music and Libations! Be sure to stop by our reception at Biga on Sunday, March 5 th at 6:30 p.m.

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Telemedicine Fraud Compliance Officers Compliance 83

MedTrainer

MAY 12, 2021

The Hidden Benefits of Regulatory Compliance in Healthcare. With its maddening complexities and time- and resource-consuming demands, regulatory compliance is thought to be the plague of any thriving business. However, according to a recent Forbes Magazine article , regulatory compliance is a golden opportunity in disguise.

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Regulatory Compliance Compliance HIPAA Medical Personnel 40

Compliancy Group

APRIL 27, 2022

Let’s Simplify Compliance HIPAA compliance helps to prevent insider data breaches. × Simplified HIPAA Compliance. Healthcare employees who misuse access rights to steal patient data to commit some other form of financial fraud. These actors steal data, commit fraud, or sabotage systems. Learn More! ×

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Fraud Compliance HIPAA Public Health 98

Compliancy Group

OCTOBER 17, 2023

With the healthcare industry constantly transforming and adapting, managing risks has become a critical aspect of ensuring patient safety, organizational resilience, and regulatory compliance. Rated #1 on G2 “Compliancy Group makes a highly complex process easy to understand.” Please Wait. Something is wrong with your submission.

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Regulatory Compliance Compliance Malpractice Fraud 52

Healthcare Law Blog

APRIL 13, 2022

Certification Adopting Code Remains Voluntary: While the Code still strongly encourages medical device companies to certify adoption of the Code and implement an effective compliance program, minor changes were made to the guidelines. beer and wine only), or disallow alcohol at certain events[.]”.

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Fraud Medical Device Industry Compliance COVID-19 52

Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

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Fraud Medicaid Medicaid Medicare 52

YouCompli

JANUARY 18, 2023

Featured speakers : Eric Gold , Chief, Massachusetts Attorney General’s Office Healthcare Division; Jennifer Goldstein , Managing Attorney, Medicaid Fraud Division, Massachusetts Attorney General’s Office; and Steven Sharobem , Assistant US Attorney, District of Massachusetts. Priorities for Massachusetts’s Medicaid Fraud Division.

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Fraud COVID-19 Compliance Medicaid 52

Healthcare IT News - Telehealth

AUGUST 11, 2021

In a session at HIMSS21 on Tuesday, two HHS OIG leaders offered a look at the enforcement priorities the agency has in mind these days, and some hints about the compliance responsibilities healthcare organizations should be prioritizing in the coming months. billion, with a B, of alleged fraud. "One scheme went for $1.6

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US Department of Health and Human Services Fraud Medicare Medicare 154

Hall Render

FEBRUARY 23, 2024

Health Care Fraud Actions Medicare Advantage. million in connection with allegations of exchange of valuable credits and sporting event tickets in exchange for sales leads. billion in settlements and judgments, over $1.8 As the largest component of Medicare, Medicare Advantage (Medicare Part C) was a target in 2023.

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Compliance Governance Medicare Medicare 71

HIPAA Journal

JULY 24, 2023

Healthcare providers participating in federal healthcare programs are advised to regularly check the HHS OIG Exclusions List to avoid penalties for non-compliance with §1128 of the Social Security Act. This article answers the following: What is the HHS Office of Inspector General? What is the HHS OIG Exclusions List?

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Fraud Medicare Medicare Medicaid 52

Total HIPAA

SEPTEMBER 11, 2019

This post aims to answer all of your HIPAA compliance questions. If you’re just learning about HIPAA compliance, or beginning the process of becoming HIPAA compliant, this article will guide you through the initial steps you must take to adhere to the law. What is HIPAA Compliance? Protected Health Information (PHI).

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HIPAA Compliance US Department of Health and Human Services Health Insurance 52

HIPAA Journal

FEBRUARY 1, 2023

In 2022, 747 of the 1,802 data breaches for which ITRC had information did not specify the root cause of the event, even though 1,595 compromises were linked to cyberattacks. “A The reason for the sudden decline in transparency is unclear, although there are several theories.

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Fraud HIPAA Ransomware Compliance 110

Provider Trust

APRIL 26, 2023

Compliance and HR managers responsible for staffing should stay apprised of events that may have repercussions within the healthcare space. However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. Compliance monitoring can get tricky with so much back and forth.

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Licensing Nurses Compliance COVID-19 52

Verisys

JANUARY 25, 2023

While sanctions lists are constantly evolving and expanding, compliance with Health and Human Services (HHS) Office of Inspector General (OIG) standards are becoming more stringent. An effective compliance program should screen and verify both employees and entities before engaging in business. states and jurisdictions.

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Compliance Fraud Telemedicine Licensing 52

AIHC

MARCH 27, 2024

Written by Meric Craig Bloch , Certified Fraud Examiner, Certified Financial Crime Specialist, Certified Compliance and Ethics Professional-Fellow, Professional Certified Investigator Does the name Meric Craig Bloch “ring a bell”? He has trained thousands of HR and compliance professionals to conduct workplace investigations.

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