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

MedTrainer

JANUARY 12, 2024

At its core, healthcare compliance ensures the quality of care, patient safety, and integrity of healthcare systems. Over the years, healthcare compliance has evolved significantly, driven by changing regulations, advances in technology, and a growing emphasis on patient-centric care. What is Healthcare Compliance?

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Compliancy Group

MARCH 19, 2024

Hospitals and private practices aren’t the only enterprises with compliance obligations within this sector. Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. name, phone number).

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Regulatory Compliance Compliance US Department of Health and Human Services ACA 52

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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Compliancy Group

JANUARY 3, 2024

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 compliance ensures that providers and administrators engage in ethical and accurate billing practices.

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Medical Billing Compliance ACA Health Insurance 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

MedTrainer

JANUARY 26, 2024

Non-compliance in healthcare refers to the failure of healthcare providers, institutions, or individuals to adhere to the laws, regulations, and standards established to protect patient welfare, maintain data security, and ensure the efficient and ethical delivery of healthcare services. What is Healthcare Compliance?

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Compliance Informed Consent HIPAA Medical Billing 52

HIPAA Journal

MARCH 15, 2023

FHKC is a state-created entity that offers health and dental insurance to children in Florida between the ages of 5 and 18. FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida.

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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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MedTrainer

OCTOBER 23, 2023

In today’s intricate healthcare landscape, compliance can mean a lot of different things, which might leave you wondering, “What is healthcare compliance?” At its core, healthcare compliance is adherence to the vast array of regulatory and procedural standards that protect patients and ensure the highest standard of care.

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Compliancy Group

DECEMBER 8, 2023

Compliance is a critical aspect of the healthcare industry. However, there are several high-risk areas where compliance issues can arise, potentially leading to legal troubles and compromised patient safety. Billing and Coding Practices Billing and coding errors are another area where compliance issues can arise.

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Compliance Medicare Medicare Fraud 52

Compliancy Group

AUGUST 31, 2023

Healthcare compliance laws play a vital role in safeguarding patients’ rights, preventing fraud and abuse, and maintaining the integrity of healthcare systems. Let’s delve into the importance of healthcare compliance laws and regulations, their impact on providers and organizations, and the guidelines governing their implementation.

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Compliance Compliance Officers Fraud Compliance Framework 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

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

Medisys Compliance

JANUARY 30, 2023

Let us discuss the top compliance issues in the medical billing industry, shall we? HIPAA: The Health Insurance Portability and Accountability Act( HIPAA) is a federal law that establishes the national standards for protecting the privacy and security of individuals’ personal health information ( PHI).

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Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

MedTrainer

OCTOBER 16, 2023

This is the essence of corporate compliance in healthcare. Just as every piece of the puzzle must fit perfectly, every compliance element in healthcare needs precise integration to ensure seamless, ethical, and effective operations. Dive with us as we explore the complexities and necessities of compliance in the healthcare sector.

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Compliance US Department of Health and Human Services HIPAA Medicaid 52

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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Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

Innovaare Compliance

MARCH 24, 2024

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1

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Fraud Health Insurance Compliance Medicaid 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

AIHC

JANUARY 5, 2023

Learn about the 7 steps to Medicare Compliance Medicare is federally regulated and requires healthcare providers to ensure that they comply with the many requirements before being eligible for reimbursement. Applying for Medicare compliance can be a daunting task for healthcare providers. What does this mean?

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Verisys

FEBRUARY 23, 2022

As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. Accordingly, maintaining compliance has become a key focus for healthcare facilities. Nine Responsibilities of Healthcare Compliance Officers.

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

MedTrainer

SEPTEMBER 20, 2023

Watch this one-demand webinar for insider tips straight from seasoned compliance surveyors. Additionally, CMS’s guidelines, or Conditions of Participation/Conditions for Coverage (CoPs/CfCs) , are specific to each type of covered health care facility, along with regulations pertaining to each organization’s state and locality.

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Medicaid Medicaid Medicare Medicare 97

Provider Trust

FEBRUARY 3, 2023

Hosted by Co-Founder of ProviderTrust Michael Rosen and Chief Compliance Officer Donna Thiel, our webinar outlined various factors affecting the healthcare space in the new year, from staffing strikes to increased scrutiny around private equity investment firms. What does this mean for compliance and oversight or management of these risks?

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American Medical Compliance

JANUARY 9, 2024

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. To become certified, please visit us at: American Medical Compliance (AMC). trillion in 2015.

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Fraud Medicare Medicare Compliance 52

Health Care Law Brief

JUNE 5, 2023

We previously wrote about the United States Department of Justice’s (“ DOJ ”) Civil Cyber-Fraud Initiative (“ CCFI ”), which “aims to hold accountable entities or individuals that put U.S. Despite not providing the foregoing, Jelly Bean represented compliance with its contract with FHKC.

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C&M Health Law

JANUARY 25, 2023

Section 4113 also requires HHS to conduct a study on program integrity related to telehealth services under Medicare Part B, including to review telehealth’s impact on future utilization of health care services (i.e., hospitalizations and emergency department visits) and to audit Medicare claims to assess potential fraud.

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Medicaid Medicaid Medicare Medicare 104

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. With Medicaid, the challenges are equally formidable.

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Fraud Medicaid Medicaid Medicare 52

HIPAA Journal

FEBRUARY 23, 2022

HIPAA is an acronym for the Health Insurance Portability and Accountability Act. When the Health Insurance Portability and Accountability Act was passed by Congress in 1996, the establishment of federal standards for safeguarding PHI was not one of the primary objectives. What is HIPAA? What is HIPAA Title II?

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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. Can I minimize risk of non-compliance with laws & regulations in healthcare?

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Compliancy Group

MARCH 8, 2023

How do people end up on the Medicaid Exclusion List, what are the consequences of being on the list, and can you ever get off the list? The Medicare Exclusion Database can trace its roots to 1996, when HIPAA (Health Insurance Portability and Accountability Act) was signed into law. Read more about medicare compliance.

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Compliancy Group

SEPTEMBER 27, 2023

Rated #1 on G2 “Compliancy Group makes a highly complex process easy to understand.” Learn More × Rated #1 on G2 for Healthcare Compliance Find Out More! While no reports of identity theft or fraud have emerged thus far related to this incident, affected individuals are urged to remain vigilant. Please Wait. Please Wait.

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HIPAA Compliance Health Insurance Fraud 52

HIPAA Journal

JULY 24, 2023

The HHS OIG Exclusions List is a database of individuals and organizations that are prohibited from participating in federal health care programs. HHS was one of the first Departments to have an Office of Inspector General in 1976 due to billions of dollars being lost each year to Medicaid fraud.

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Fraud Medicare Medicare Medicaid 52

AIHC

MAY 30, 2024

These technologies have become a core function in RCM Operations and have also been adopted by the Health Insurance, Health System, and Provider communities across the United States. Compliance and Risk Management : Fraud Detection : AI systems can identify unusual patterns that may indicate fraudulent activities.

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Compliance HIPAA Regulatory Compliance Medical Billing 52

MedTrainer

AUGUST 2, 2023

Auditing helps healthcare organizations maintain accurate and appropriate documentation, optimize revenue, minimize compliance risks, and improve overall operational efficiency. The Importance of Medical Auditing From a compliance standpoint, medical auditing serves several important purposes within healthcare organizations.

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Healthcare Compliance Blog

MARCH 31, 2022

The agencies received millions of dollars in funding from Medicaid, which is funded in part by the federal government, and much of that money was meant to pay the wages and benefits of their aides. Under the Wage Parity Law, which is funded by Medicaid, aides are to be paid a minimum amount in total compensation.

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Healthcare IT News - Telehealth

JULY 2, 2020

Secretary of Health and Human Services Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma to provide a written plan for permanent changes to Medicare, Medicaid and Children’s Health Insurance Program rules around telehealth.

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Florida Health Care Law Firm

JANUARY 20, 2022

The Agency for Health Care Administration (AHCA) in Florida was created by Chapter 20 of the Florida Statutes and serves as the primary health policy and planning institution for all of Florida. Florida’s Medicaid program is worth $25.2 Health plan enrollment, rates, contracts, and related information.

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