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Managing Healthcare Compliance in Ohio

MedTrainer

Managing healthcare compliance in Ohio presents a unique set of challenges for compliance officers, healthcare professionals, and administrators. Organizations need to successfully navigate the regulatory landscape in order to provide efficient and ethical healthcare services, and to avoid consequences for non-compliance.

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How To Prepare for an OIG Inspection

MedTrainer

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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Are Provider Enrollment and Credentialing the Same?

MedTrainer

Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. Provider enrollment confirms the healthcare provider meets and maintains certain compliance standards for the insurance or payer network. What is Provider Enrollment?

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Primary Source Verification: One of the Hidden Secrets to Ensuring Excellence in Any Healthcare Organization

Verisys

Compliance with regulatory standards Compliance with regulatory standards from CMS or other regulatory-setting bodies should be non-negotiable. Mitigating liability and legal risks Malpractice claims and legal disputes can financially and emotionally drain healthcare providers and organizations.

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Introduction to Telebehavioral Health

AIHC

Compliance Considerations for Best Outcomes Written in collaboration with the AIHC Volunteer Education Committee Delivering mental health services via telehealth has increased since the COVID-19 pandemic. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs.

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The Importance of Primary Source Verification for Practitioner Credentials

Verisys

An Office of Inspector General (OIG) search of the List of Excluded Individuals/Entities (LEIE) indicates if the licensee is excluded from participating in government-funded programs. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs.

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Quick Guide to the National Practitioner Data Bank (NPDB)

Provider Trust

Department of Health and Human Services (HHS) and contains medical malpractice payments and adverse action reports on healthcare professionals. Below are the significant laws and regulations that govern NPDB operations: NPDB Regulations. The New Standard in Compliance Intelligence. Healthcare Legislation & Regulations.