Verisys

JANUARY 8, 2024

A healthcare compliance audit is a thorough review and examination of an organization’s adherence to regulatory guidelines. This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations.

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Compliance Regulatory Compliance Health Insurance Medicaid 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.

Compliance 52

Compliance Regulatory Compliance Governance Fraud 52

MedTrainer

JANUARY 26, 2024

That means there’s a direct relationship between compliance and a healthcare organization’s revenue. To answer the question “how does compliance have an impact on financial management in healthcare,” we first need to explore the connections between the two. What is Healthcare Compliance?

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Compliance Fraud Regulatory Compliance Health Insurance 52

Healthcare IT Today

DECEMBER 21, 2023

The following is a guest article by Mitchell Perry, VP Compliance & Security at Access In the ever-evolving landscape of healthcare IT in US healthcare frameworks, integrating electronic health records (EHRs) has become a cornerstone for providers. If healthcare providers fail to comply, the consequences can be costly.

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Records Management Regulatory Compliance Compliance HIPAA 100

Compliancy Group

OCTOBER 2, 2023

In the fast-paced world of healthcare, compliance reporting plays a vital role in ensuring accountability and transparency. This article will explore the significance of compliance reporting in healthcare and how it helps organizations maintain data integrity and mitigate risks. What is Compliance Reporting in Healthcare?

Compliance 52

Compliance Regulatory Compliance Fraud Health Insurance 52

Verisys

FEBRUARY 14, 2024

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is healthcare data governance?

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Governance Compliance Regulatory Compliance Compliance Framework 52

MedTrainer

NOVEMBER 2, 2023

This critical responsibility rests on the shoulders of the healthcare compliance officer. Read on if you’ve ever wondered about the unsung heroes as we answer the question: What does a compliance officer do in healthcare? What Is the Primary Role of a Compliance Officer in Healthcare?

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Compliance Officers Compliance HIPAA Regulatory Compliance 52

Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. Findings from OIG audits can identify compliance areas needing improvement.

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Compliance Officers Compliance Medicare Medicare 52

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

Healthcare IT Today

JUNE 29, 2023

Each ASC is responsible for ensuring that they are in compliance with the numerous statutes and regulations that are in place at both the state and federal levels. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. ASC billing compliance has many benefits.

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Compliance Medicare Medicare Medical Billing 52

Verisys

NOVEMBER 30, 2022

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. Excluded from one means excluded from all, and the fines for non-compliance will likely be in the hundreds of thousands. How many data sources is your organization monitoring? And Thousands More….

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Regulatory Compliance Medicare Medicare Medicaid 52

Health Care Law Brief

JUNE 2, 2022

In addition, the PHE fueled a boom in the number of direct-to-consumer (“DTC”) telehealth platforms, many of which have relied upon COVID-19 regulatory waivers to launch and operate in multiple states across the nation. Concerns Proliferate for Telehealth Platforms. Provider Licenses.

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Innovaare Compliance

JUNE 8, 2023

These changes, which went into effect on January 1, 2023, are designed to ensure health plans are accurately reporting their costs and that they are not overcharging the government. Review your financial arrangements: Make sure that your financial arrangements with providers are in compliance with CMS regulations.

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Medicaid Medicaid Medicare Medicare 52

HIT Consultant

MAY 4, 2023

But with so many competing training programs — everything from HIPAA and regulatory compliance to handwashing and job-specific training — it’s difficult to break through the noise and gain traction. Some healthcare organizations are minimally training their staff for compliance, hoping it will be sufficient.

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Hospitals Regulatory Compliance HIPAA Compliance 97

Healthcare Law Today

DECEMBER 12, 2022

In this episode of Health Care Law Today, Nate Lacktman and Maureen Stewart are joined by Mark Josephs, Deputy General Counsel of LifeMD to discuss the current regulatory and legal environment for telemedicine companies regarding online subscription services, and the recent investigations by the federal government of these services.

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Telemedicine Fraud Governance Compliance 49

Health Law Advisor

JULY 14, 2023

EBG works closely, under attorney-client privilege, with organizations to conduct risk assessments and to identify recognized security practices that may bolster practical security and improve compliance defensibility.

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Regulatory Compliance Fraud Compliance Governance 52

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

Health Care Law Brief

FEBRUARY 7, 2022

It is unclear, however, whether this new regulatory framework will ultimately benefit requestors. See e.g. , Advisory Opinion 21-10 as an example of the former, available at Advisory Opinion 21-10 | Office of Inspector General | Government Oversight | U.S. at 1368 (emphasis added). However, OIG’s sentiment may presume too much.

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Fraud Governance Compliance Regulatory Compliance 52

Health Care Law Brief

APRIL 11, 2022

Notwithstanding these streams of remuneration taking the form of cash equivalents and not being protected by an AKS regulatory safe harbor or by an exception to the Beneficiary Inducements CMP, the OIG still concluded that the Arrangement presented a minimal risk of fraud and abuse based on a totality of the underlying facts and circumstances.

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Fraud Medicare Medicare Compliance 52

Health Care Law Brief

JULY 21, 2022

On July 20, 2022, the Office of Inspector General for the Department of Health and Human Services (“ OIG ”) issued a special fraud alert (“ Alert ”) advising “practitioners to exercise caution when entering into arrangements with purported telemedicine companies.” OIG Flags Seven Characteristics of Telehealth Fraud.

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Fraud Telemedicine COVID-19 Governance 52

MedTrainer

AUGUST 30, 2023

Let’s explore what it means for an MCO to coordinate care for members, and the compliance implications that come with this healthcare services model. Understanding how each type of MCO works provides a baseline for understanding the necessary compliance considerations that accompany them. What’s Needed for MCO Compliance?

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Compliance Regulatory Compliance Medicaid Medicaid 52

MedTrainer

AUGUST 2, 2023

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. However, it’s important to remember how critical this process is for mitigating risk, improving compliance, and earning trust.

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Malpractice Due Diligence Compliance Licensing 52

Florida Health Care Law Firm

DECEMBER 2, 2021

On November 8, 2021, The Department of Health & Human Services (HHS), Office of Inspector General (OIG) released a revised and renamed Provider Self-Disclosure Protocol (SDP), now known as the “Health Care Fraud Self Disclosure “protocol. The OIG recognized that there are benefits to disclose potential fraud.

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Overpayments Overpayment Fraud Medicare 40

Health Care Law Brief

MARCH 8, 2022

Under both options, the Direct Contracting Entity’s (DCE) Participating Providers must have held at least 25% of the governing board voting rights. In tandem with these protections, CMS will not allow current DCEs in the GPDC Model to continue participating in the ACO REACH Model unless they can demonstrate a “strong compliance record.”

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Medicare Medicare Fraud Compliance 52

Drug & Device Law

DECEMBER 29, 2023

2023) (federal government may unilaterally obtain dismissal of FCA claims, and calling the constitutionality of the FCA’s private enforcement mechanism into question) ( here ); Quishenberry v. 2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. In 2023, these include United States ex rel. Polansky v. 3d 239 (Cal.

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FDA US Department of Health and Human Services COVID-19 Informed Consent 105