Verisys

MARCH 6, 2025

Emerging technologies arent siloed to the hospital floor or operating room. What Is AI in Healthcare Compliance? Imagine having a tireless assistant who handles the nitty-gritty of regulatory compliance so healthcare teams can focus on what matters mostpatient care and privacy. A 2024 survey of U.S.

Compliance 52

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

Verisys

MARCH 6, 2025

In the healthcare industry, compliance with regulatory standards is not merely a requirement but a cornerstone of safe, effective, and ethical patient care. When healthcare organizations fail to meet compliance standards, the consequences can be severespanning legal and financial realms. What is Non-Compliance in Healthcare?

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Compliance HIPAA Licensing Governance 52

American Medical Compliance

FEBRUARY 21, 2025

AMC (American Medical Compliance) has achieved a major milestone by expanding into the UAE, Saudi Arabia, and the broader Middle East, reinforcing its position as a key player in global healthcare compliance.

Compliance 71

Compliance ADA Governance Medical Billing 71

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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Compliance Compliance Officers Fraud HIPAA 109

Compliancy Group

AUGUST 28, 2024

Human resources (HR) professionals have a stake in their organizations’ healthcare compliance practices. Regardless of company size or number of employees, thorough HR compliance training ensures that your practice, hospital, or company protects patients and workers.

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Compliance Fraud Regulatory Compliance HIPAA 97

American Medical Compliance

AUGUST 7, 2024

Notably, many of these incidents are preventable and could have been avoided with proper compliance measures. Compliance with healthcare regulations is crucial not only for avoiding legal repercussions but also for ensuring high standards of patient care and safety. It ensures its confidentiality and maintains security.

Compliance 105

Compliance HIPAA Medicaid Medicaid 105

Bill of Health

OCTOBER 30, 2023

In another legal case, a “moon” emoji was found to be possible evidence of securities fraud. Public Health Awareness First, hospitals might try to reach patients through engaging ads that deploy emojis. The Stark Law requires hospital advertisements disclose when physicians may have financial conflicts of interest.

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Doctors Hospitals Fraud Health Insurance 290

Hall Render

MARCH 4, 2025

Department of Health and Human Services (HHS) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursing home members of the health care compliance community. Medical Directors in Nursing Homes 42 CFR 483.70(g) See 42 C.F.R.

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Compliance Nursing Homes Nurses Medicare 52

Healthcare IT Today

DECEMBER 26, 2024

Check out our community’s Healthcare Cybersecurity predictions: Bill Murphy, Director of Security and Compliance at LeanTaaS As we enter 2025, AI is revolutionizing cyber threats in concerning ways. Recent incidents involving fake video calls and voice cloning demonstrate the technology’s potential for sophisticated fraud.

US Department of Health and Human Services 90

US Department of Health and Human Services Ransomware Compliance Hospitals 90

Total Medical Compliance Resources

NOVEMBER 11, 2024

Total Medical Compliance is excited to announce the launch of its new suite of online courses designed to enhance the skills and knowledge of healthcare professionals. link] HIPAA Fraud, Waste, and Abuse Awareness Course $30.00 Our new online course on HIPAA regulations equips employees to combat fraud, waste, and abuse in healthcare.

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ADA HIPAA Compliance Fraud 59

Compliancy Group

MAY 15, 2024

As we move deeper into 2024, hospitals must increasingly focus on compliance with regulations set forth by the Office of Inspector General (OIG). This guide outlines the OIG’s hospital compliance priorities and provides actionable advice on ensuring your hospital meets these rigorous standards.

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Compliance Hospitals Fraud Regulatory Compliance 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.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Healthcare It News

DECEMBER 5, 2022

" Community also said that the investigation has not found evidence that misuse or fraud has occurred as a result of the breach, and it "cannot say with certainty what information was involved."

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Fraud HIPAA Compliance Hospitals 294

HIT Consultant

DECEMBER 18, 2024

Identity theft, fraud, and long-term financial harm are just a few examples of the personal fallout patients may face following a data breach. Ensuring compliance with regulatory standards not only fortifies security but also cultivates patients’ trust, underpinning a more secure and efficient healthcare environment.

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Ransomware Fraud Doctors HIPAA 105

Healthcare IT Today

NOVEMBER 22, 2024

At the height of the COVID pandemic in 2020, several hospitals across the country were targeted in ransomware attacks. This forced hospitals to divert patients for care, delaying treatment, and resulting in the loss of thousands of patient records.

Ransomware 67

Ransomware Hospitals COVID-19 Compliance 67

Compliancy Group

APRIL 25, 2024

Maintaining Medicare compliance and avoiding legal and financial repercussions requires Medicare compliance training for employees at all organizational levels. Examples of Medicare fraud include billing for unrendered services and using a billing code or a service that’s more expensive than what a patient received.

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Fraud Medicare Medicare Compliance 59

Healthcare IT Today

MARCH 19, 2025

These events expose the limitations of traditional systems in combating emerging threats like AI-generated fraud and identity manipulation. Recent incidents, such as the massive theft of NHS records in 2024 and a surge in ransomware attacks on healthcare providers, emphasize the urgent need for stronger security frameworks.

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Fraud Ransomware HIPAA Compliance 60

Healthcare Blog

JANUARY 19, 2025

CMS Medicare Swing Bed Rules and Regulations for Critical Access Hospitals (CAHs) Critical Access Hospitals (CAHs) are the backbone of rural healthcare, providing essential services to underserved communities. This flexibility benefits both the hospital and the patient. Prevent fraud and abuse of Medicare funds.

Medicare 52

Medicare Medicare Compliance Nurses 52

Healthicity

OCTOBER 5, 2022

The Office of Inspector General recently made Work Plan updates that impact price transparency rules, Medicaid fraud referrals, and inpatient rehabilitation. If you support compliance for hospitals or hospital systems, listen up! Have you heard? Our latest eBrief covers the updates you need to know.

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Fraud Medicaid Medicaid Compliance 98

HIPAA Journal

JUNE 15, 2023

A relatively small data breach was reported to OCR on February 28, 2018, by Yakima Valley Memorial Hospital (formerly Virginia Mason Memorial), a 222-bed non-profit community hospital in Washington state. So far this year, penalties totaling $1,901,500 have been imposed by OCR to resolve violations of the HIPAA Rules.

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HIPAA Hospitals Electronic Medical Records Fraud 98

Compliancy Group

JULY 10, 2024

Compliance with healthcare regulations protects patients, safeguards employee safety, and maintains the security of electronic medical records (EMRs) and cyber networks. Ensuring compliance with critical regulations falls on the compliance officer. What Does a Compliance Officer Do?

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Compliance Officers Compliance Fraud Electronic Medical Records 64

HIT Consultant

JANUARY 12, 2025

AI-generated identity fraud, including deepfakes, and other sophisticated tactics are making traditional security systems obsolete. Facial recognition provides fast and precise identification, which is particularly valuable in high-traffic areas such as hospitals.

Fraud 64

Fraud Regulatory Compliance Ransomware Compliance 64

Compliancy Group

FEBRUARY 26, 2024

In the evolving healthcare industry, adhering to compliance rules and standards while staying on top of regulatory changes is paramount. A comprehensive hospital compliance work plan is pivotal for achieving these objectives. A comprehensive hospital compliance work plan is pivotal for achieving these objectives.

Compliance 52

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

Med-Net Compliance

JUNE 22, 2022

A registered nurse from a veteran’s hospital in Detroit pleaded guilty to charges related to COVID-19 vaccination record cards fraud. Employees and applicants of healthcare facilities must provide truthful information regarding their vaccination status and understand the penalties for engaging in fraud.

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COVID-19 Vaccine COVID-19 Fraud US Department of Health and Human Services 59

Verisys

DECEMBER 29, 2024

This includes verifying education, residency, employment history, malpractice insurance, hospital privileges, and board certifications. Healthcare organizations and insurance companies rely on credentialing to ensure patient safety, regulatory compliance, and minimize liability risks.

Malpractice 52

Malpractice Licensing Regulatory Compliance Hospitals 52

Healthcare IT Today

MARCH 26, 2025

As the sector adapts, telehealth providers must navigate new compliance challenges, particularly regarding controlled substances, data privacy, and multi-state licensing. Telehealth providers must align with organizations like LegitScript , which certifies compliance with regulatory standards.

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FDA Compliance Licensing Fraud 52

American Medical Compliance

JULY 9, 2024

The Medicare FWA Compliance Training aims to educate healthcare providers (HCP) on the definitions of fraud, waste, and abuse in the context of Medicare. American Medical Compliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education to physicians.

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Medicare Medicare Compliance Fraud 52

HIT Consultant

MAY 4, 2023

Monitoring and maintaining the security of IT infrastructure is often overemphasized within hospitals and health systems, while the human side of reducing risk is often under-emphasized. The answer is training, continual training to help create a culture of security within your hospital or health system.

Hospitals 97

Hospitals HIPAA Regulatory Compliance Compliance 97

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital.

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Fraud Compliance Medicaid Medicaid 98

Healthcare IT Today

NOVEMBER 19, 2020

The following is a guest article by Donna Thiel, Chief Compliance Officer at ProviderTrust. Although there may be numerous benefits to using telehealth services, patients and providers should also consider the substantial telehealth risks involved.

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Compliance COVID-19 Compliance Officers Ransomware 90

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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Fraud Compliance Governance Compliance Officers 52

Compliancy Group

JUNE 27, 2024

Completing compliance incident reports is crucial to reducing the number of accidents in the future and understanding why they occur. Understanding what incidents need reporting and how to complete an incident report can help providers, compliance officers, and other personnel maintain the highest safety standards.

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Compliance Compliance Officers Fraud Nurses 64

Compliancy Group

DECEMBER 20, 2024

In May of 2015, the NYPD informed Montefiore Medical Center that there was evidence that patient information had been stolen from the hospitals database – leading Montefiore to investigate and discover that the theft had taken place two years earlier. The settlement is the third ransomware settlement entered into by OCR.

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Ransomware HIPAA Fraud Electronic Medical Records 98

Healthcare IT Today

MAY 10, 2022

Contract Enforcements Tie Cybersecurity to Financial Fraud and Liability The receptionist you yelled at for shopping online could turn you in and get a $900,000 reward. When it comes to compliance, ignoring the contracts you sign – including with Medicare and your insurance policies – can hit you really hard and really fast.

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Fraud Medicare Medicare Compliance 110

AIHC

SEPTEMBER 3, 2024

Celebrating the Healthcare Compliance Officer The American Institute of Healthcare Compliance is recognizing healthcare Compliance Officers – hats off to you! The primary goal of a compliance officer is to mitigate risk. This involves investigating complaints and conducting internal auditing and monitoring for compliance.

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Compliance Officers Compliance Fraud Medicare 52

American Medical Compliance

MAY 22, 2023

million to settle allegations that it paid kickbacks to healthcare providers committing fraud violations. Department of Justice accused the company of violating the False Claims Act by paying kickbacks to physicians and hospitals in exchange for using their products. DePuy Synthes recently agreed to pay $9.75 Agrees to Pay $9.75

Fraud 52

Fraud Compliance Governance Doctors 52

Healthcare IT Today

FEBRUARY 7, 2025

Enhanced Compliance and Fraud Detection Compliance is critical in medical billing, especially with the ever-changing healthcare regulations. AI tools continuously monitor updates in billing codes and ensure that all submissions adhere to the latest standards.

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Medical Billing Medical Billing Services Fraud Compliance 52