MedTrainer

JANUARY 10, 2024

It may seem a little early to do some spring cleaning, but not when it comes to compliance! It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. The OIG is making major investments to systematically detect and prosecute fraud.

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Compliancy Group

FEBRUARY 12, 2024

Fraud in healthcare has run rampant in recent years, as evident by two incidents in which healthcare organizations billed insurance companies for things patients never received. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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Healthcare IT Today

JANUARY 19, 2021

The Federal Trade Commission (FTC) announced a consumer fraud settlement against a company that displayed a ‘HIPAA Compliant’ seal on its website.

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Provider Trust

APRIL 18, 2024

This comprehensive program provides healthcare organizations across the continuum of care a roadmap to implement top-tier compliance standards by addressing key population monitoring gaps, prioritizing financial efficiencies, and upholding community healthcare and success.

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Compliancy Group

DECEMBER 15, 2023

Differentiating Fraud, Abuse, and Waste Detecting and stopping fraud, abuse, and waste rely on distinguishing these behaviors in the healthcare context. What is Healthcare Fraud? Providers commit Medicare and Medicaid fraud when they knowingly submit or contribute to the submission of a false claim for financial gain.

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Hall Render

NOVEMBER 21, 2023

The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. This category of individuals is sometimes called a “fraud alert employee.” Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C.

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Compliancy Group

MARCH 22, 2024

As a compliance officer or critical decision-maker, you can help your healthcare organization avoid exclusion from this valuable program by creating a comprehensive compliance program and using software to streamline your compliance processes. Remaining in good standing with Medicare has several advantages.

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Verisys

JANUARY 8, 2024

OIG compliance refers to adherence to the guidelines and regulations set forth by the Office of Inspector General (OIG) of the U.S. The OIG is responsible for combating fraud, waste, and abuse in health and human services programs, including Medicare and Medicaid. The post What is OIG Compliance? appeared first on Verisys.

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Compliancy Group

APRIL 8, 2024

Patient safety and regulatory compliance are paramount, and healthcare organizations face numerous challenges in effectively managing their operations. The complex nature of the healthcare industry calls for a robust framework to ensure governance, mitigate risks, and maintain compliance with various regulations.

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Compliancy Group

MARCH 21, 2024

It’s challenging enough to stay on top of constantly changing compliance regulations in healthcare, including training. Instead of continuously working hard to maintain all these administrative and logistical functions, you can be more innovative by letting compliance training software do the heavy lifting.

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

American Medical Compliance

FEBRUARY 9, 2024

Compliance officers’ responsibilities extend far beyond merely checking boxes and ticking off regulatory requirements. In fact, 61% of the compliance teams from a Thomson Reuters report also work on long-range strategies for their companies by putting regulatory and legislative changes as a top priority.

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MedTrainer

JANUARY 31, 2024

Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program? It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. What is Healthcare Compliance?

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Compliancy Group

MARCH 12, 2024

must also be mindful of these healthcare compliance frameworks. A Compliance Framework for the U.S. healthcare compliance framework serves these purposes: Protect patient privacy : Health records and protected health information must remain confidential and private, with only essential providers and personnel having access to it.

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MedTrainer

MARCH 8, 2024

Employee compliance training is essential to any healthcare organization’s onboarding process. This blog post will explore why compliance training is vital for an industry where mistakes or non-compliance can seriously affect patients, staff, and the organization.

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Compliancy Group

FEBRUARY 28, 2024

Many industries have compliance rules and regulations to meet and follow, but few would argue that healthcare is one of the most stringent. Privacy and security – Compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations to protect patient privacy and data security is crucial.

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MedTrainer

JUNE 28, 2023

In healthcare especially, fraud is something responsible providers need to be on the lookout for. It’s why many organizations choose to work with a Certified Fraud Examiner as part of their ongoing efforts to remain responsible and compliant with financial best practices. What is a Certified Fraud Examiner?

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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.

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Total Medical ComplianceHIPAA

APRIL 12, 2024

As healthcare providers navigate the complex web of rules and regulations in compliance, one aspect that needs more attention is exclusion screening of those working with federally funded healthcare programs. Non-compliance with these requirements could result in financial penalties and jeopardize participation in Federal healthcare programs.

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Health Law Checkup

MARCH 13, 2023

The carrot or the stick … which motivates compliance conduct more? Department of Justice to motivate or cajole corporate compliance. In separate announcements over the past several weeks, DOJ dangled two new “carrots” in front of companies involved in fraud investigations and criminal cases.

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Verisys

MARCH 1, 2024

As the healthcare industry is increasingly targeted for data theft and fraud, information security has emerged as a top priority for healthcare institutions. Governance, risk management, and compliance programs can all be automated, providing significant benefits to healthcare organizations.

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Compliancy Group

FEBRUARY 9, 2024

One crucial tool that helps healthcare organizations achieve this is compliance program guidance documents. These comprehensive guidelines are designed to assist various healthcare settings in implementing effective compliance programs, ensuring that they operate within legal boundaries while providing quality care to patients.

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Verisys

FEBRUARY 8, 2024

Verisys can assist pharmaceutical manufacturers in maintaining compliance with OIG guidelines and other regulatory requirements through a multifaceted approach, leveraging its extensive suite of data solutions and compliance services. The post Pharmaceutical Manufacturers Guide to OIG Compliance appeared first on Verisys.

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Compliancy Group

APRIL 4, 2024

These are just some of the things that OIG compliance guidelines help prevent. Since 1976, the Office of Inspector General (OIG) has helped healthcare organizations prevent and fight against fraud, waste, and abuse. These things are often handled separately when, in reality, they should be connected to your compliance initiatives.

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Compliancy Group

FEBRUARY 22, 2024

The healthcare industry faces an ever-increasing number of essential regulations, making developing a reliable compliance strategy crucial. Have you explored the best path to ensure peak healthcare compliance officer training?

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American Medical Compliance

APRIL 6, 2023

Incidence of Healthcare Fraud Numerous scammers view this as a method to make quick, yet unlawful, money. Officials state that Florida, along with the rest of the nation, has been plagued by healthcare fraud. AMC is also a leader in the industry for compliance, Billing, and HR solutions. Reference NPR. 2023, January 27).

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Health Care Law Brief

FEBRUARY 7, 2024

Department of Health and Human Services Office of Inspector General’s (OIG) core responsibility is to promote efficiency and economy in myriad programs by eliminating fraud, waste and abuse. Copyright 2024 Compliance Today , a publication of the Health Care Compliance Association (HCCA).

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MedTrainer

APRIL 8, 2024

As a healthcare professional, it is vital to maintain compliance with the 629 legal and regulatory requirements that govern the delivery of quality care. One effective tool to achieve this is through internal healthcare compliance audits. What Is an Internal Healthcare Compliance Audit?

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MedTrainer

JANUARY 12, 2024

Healthcare compliance is serious business for regulators. In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. What is Healthcare Compliance? Who Regulates Healthcare Compliance?

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Health Law RX

JANUARY 30, 2024

By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The DOJ Announcement stresses the importance of investing in strong compliance programs for both the buyers and sellers in business transactions.

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MedTrainer

FEBRUARY 1, 2024

Those early ethical standards paved the way for how medical compliance plans to limit liability for healthcare organizations today. Here’s how these plans help limit liability: Prevent Fraud and Abuse: Compliance plans include measures to prevent fraud and abuse within the healthcare organization.

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American Medical Compliance

MARCH 13, 2023

The United States Department of Justice charged 36 defendants for healthcare fraud that amounted to over $1 Billion. Healthcare organizations must take all possible steps to prevent instances of fraud. Employees should receive training that educates them on how to identify, report, and combat fraud, waste, and abuse in the workplace.

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MedTrainer

FEBRUARY 1, 2024

A corporate compliance program in healthcare is a comprehensive set of policies, procedures, and practices that healthcare organizations establish and maintain to ensure that they operate compliant with all applicable laws, regulations, and ethical standards. Why do healthcare facilities use corporate compliance programs?

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MedTrainer

FEBRUARY 12, 2024

How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims? In this blog, we’ll share how healthcare organizations are managing compliance around false claims and safeguarding both the integrity of healthcare services and the welfare of patients.

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AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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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

JANUARY 22, 2024

Critical Components of a Healthcare Compliance Audit Checklist There are several necessary components in a comprehensive healthcare compliance audit checklist that help maintain adherence to regulatory standards. Compliance Assessment Ensuring compliance with applicable laws and regulations is fundamental to any healthcare audit.

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Healthcare Law Blog

NOVEMBER 9, 2023

In late April this year, the Office of Inspector General, Department of Health and Human Services (OIG) announced that it would make changes to its existing body of healthcare compliance program guidance (CPGs) as part of its current Modernization Initiative. [1] On November 6, 2023, OIG finally published the GCPG on its website [3].

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