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?

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 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?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Compliancy Group

APRIL 17, 2024

OIG Medicare compliance audits help ensure that hospitals, clinics, and other medical facilities use program funds efficiently and in accordance with federal and state laws. Findings from OIG audits can identify compliance areas needing improvement. They also help the DHHS improve its operations and program administration.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

MedTrainer

OCTOBER 5, 2023

As a key member of your facility’s healthcare compliance programming, you understand the significance of regulatory compliance and the critical role it plays in ensuring the privacy and security of patient information. Use this guide for creating the reports you need to satisfy OCR and other governing body inspections.

HIPAA 98

HIPAA Compliance Regulatory Compliance ADA 98

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. Medicaid Managed Care. Some state Medicaid programs contract with managed care organizations to provide healthcare services to eligible beneficiaries. Quality of Care Standards.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Verisys

DECEMBER 22, 2021

Should a group health plan, insurer, or state agency find that time is running out on achieving regulatory compliance with H.R. As a product manager at the healthcare technology and services company Verisys , he guides many of the solutions that support health plans, health systems, and state Medicare and Medicaid agencies.

Compliance 52

Compliance Regulatory Compliance Healthcare information Technology Health Insurance 52

Medisys Compliance

MARCH 7, 2024

These codes are integral to the billing and reimbursement process, as they enable payers, such as insurance companies and government agencies, to determine the appropriate payment for rendered services. Moreover, CPT codes facilitate data analysis, research, and quality improvement initiatives within the healthcare system.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Regulatory Compliance Compliance 59

Innovaare Compliance

JUNE 8, 2023

The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. 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.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Verisys

NOVEMBER 30, 2022

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. organizations that receive any funds from Medicare, Medicaid, TRICARE, or other federal programs cannot afford to employ individuals or entities excluded from even one program. 38 Medicaid Sanctions.

Regulatory Compliance 52

Regulatory Compliance Medicare Medicare Medicaid 52

HIT Consultant

APRIL 16, 2024

Eric Demers, CEO Madaket Health In 2022, the Centers for Medicare & Medicaid Services (CMS) proposed the creation of a centralized physician directory. The regulatory landscape only strengthens CMS’ case for a centralized physician directory. A growth-minded leader, Eric has founded three companies and exited two.

Regulatory Compliance 52

Regulatory Compliance Compliance Health Insurance Medicaid 52

Medisys Compliance

JUNE 14, 2023

Regulatory Compliance Another significant challenge in medical billing is ensuring compliance with the complex web of healthcare regulations. To address this challenge, healthcare organizations must implement robust compliance programs.

Medical Billing 52

Medical Billing Medical Billing Services Medical Billing Outsourcing Regulatory Compliance 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. Does the state apply different standards, for example, to Medicaid encounters? How is this disclosed to consumers?

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Medisys Compliance

APRIL 25, 2023

Need of Choosing Oncology Billing Company As an oncology practice, selecting the right billing company is a crucial decision that can significantly impact your financial success and regulatory compliance. On the other hand, a wrong choice can lead to delayed payments, billing mistakes, and even regulatory non-compliance issues.

Regulatory Compliance 52

Regulatory Compliance Compliance Medical Billing Outsourcing ACA 52

HIT Consultant

AUGUST 3, 2022

Medicaid reimbursement, which comprises the largest share of nursing home reimbursement, has not kept pace, resulting in SNFs and medical providers assuming the burden of those costs. . A Regulatory compliance and survey process both distract and often assault a beaten-up staff and push people out of service to the facilities.

Nursing Homes 98

Nursing Homes Nurses COVID-19 Medicaid 98

MedTrainer

AUGUST 2, 2023

After that, the credentialing process is periodically reviewed and renewed to ensure ongoing compliance with standards and regulations. However, it’s important to remember how critical this process is for mitigating risk, improving compliance, and earning trust. Why Is Provider Credentialing Important?

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Verisys

OCTOBER 23, 2023

Here is our monthly regulatory update. A big thanks to our compliance team, who monitors state, federal, and international updates. Medicaid providers are no longer required to use the centralized credentials verification organization to complete enrollment requirements. – The best resource for monthly updates.

Licensing 52

Licensing Nurses Compliance Medicaid 52

Healthcare Law Today

JANUARY 20, 2022

Finally, billing and coding mistakes can have an adverse effect on earnings, value, and create compliance concerns. Thus, compliance with the AKS is vital to the health of the overall relationship. This is especially important given new legislation and regulatory guidance regarding surprise billing. Section1320a-7b).

Compliance 52

Compliance Medicare Medicare COVID-19 52

Florida Health Care Law Firm

DECEMBER 2, 2021

As described on the OIG website, “Self-disclosures give persons the opportunity to avoid the costs and disruptions associated with a Government-directed investigation and civil or administrative litigation.”. Each case will be determined individually.

Overpayments 40

Overpayments Overpayment Fraud Medicare 40

Health Care Law Brief

MARCH 8, 2022

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, which will begin January 1, 2023, and replace the Global and Professional Direct Contracting (GPDC) Model.

Medicare 52

Medicare Medicare Fraud Compliance 52

HIT Consultant

OCTOBER 4, 2021

The Centers for Medicare and Medicaid Services (CMS) strive for innovations in healthcare technologies that drive down costs and improve the patient experience. But they also significantly increase the risk of data breaches, requiring all healthcare organizations to layer an effective security and governance protection over those new APIs.

Regulatory Compliance 52

Regulatory Compliance Governance Medicaid Medicaid 52

Health Care Law Brief

NOVEMBER 9, 2021

Additionally, and as we touched upon in our January 7, 2021 post on the No Surprises Act , these new measures supplement state laws governing surprise medical billing, and so in cases where a state No Surprises law applies, the state law generally determines an individual’s OON payment rate. [1]. Patient-Provider Dispute Resolution.

Medical Billing 75

Medical Billing Due Diligence Compliance Patient Satisfaction 75

Drug & Device Law

JANUARY 25, 2024

But the UHC entities included Medicare Advantage Organizations (“MAOs,” not to be confused with monoamine oxidase inhibitors or any particular potentate) regulated by the Centers for Medicare and Medicaid Services (“CMS”) applying various Medicare laws and regulations. Darue Eng’g & Mfg. ,

Medicare 52

Medicare Medicare FDA Regulatory Compliance 52