YouCompli

FEBRUARY 22, 2023

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. The CCR is determined by a hospital’s cost report that is reconciled with the local Medicare contractor.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

HIPAA Journal

JANUARY 30, 2023

The National HIPAA Summit is the leading forum on healthcare EDI, privacy, breach notification, confidentiality, data security, and HIPAA compliance, and the deadline for registration for the Virtual 40th National HIPAA Summit is fast approaching.

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US Department of Health and Human Services HIPAA Compliance Medicaid 81

Medisys Compliance

JULY 25, 2022

Recently published watchdog report found that private Medicare plans routinely rejected claims that should have been paid and denied services that reviewers found to be medically necessary. For detailed understanding we shared observations of OIG where they found that some of the claims were wrongly denied by private Medicare plans.

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Medicare Medicare US Department of Health and Human Services Medical Billing Outsourcing 52

Healthcare IT Today

MAY 16, 2024

Mike Semel, President and Chief Security Officer of Semel Consulting The Ascension health system data breach can’t be easily separated from the United Healthcare Change Health breach that recently caused a huge financial and medical impact across the healthcare sector and may have breached the personal information for a third of Americans.

Ransomware 77

Ransomware US Department of Health and Human Services Hospitals Compliance 77

Healthcare Compliance Blog

MAY 9, 2022

A home health services company headquartered in Kentucky, and its related entities, paid $2.1 million to the United States government to settle claims of improperly billing the Medicare Program for home health services provided to beneficiaries living in Florida.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Compliance 59

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. Identifying potential risks.

Compliance Officers 52

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

Healthcare Compliance Blog

APRIL 26, 2022

The Office of Inspector General (OIG) for the US Department of Health and Human Services (HHS) has made educational resources available for healthcare providers to comply with federal healthcare laws and regulations. Voluntary Compliance: OIG has several self-disclosure processes to report fraud in HHS programs.

US Department of Health and Human Services 59

US Department of Health and Human Services Fraud Compliance Medicaid 59

Healthcare Compliance Blog

MAY 19, 2022

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. Following an internal review and audit, the hospital discovered irregularities regarding its billing of certain services, and proactively contacted the United States to self-disclose the issues.?The to resolve the claims.

US Department of Health and Human Services 59

US Department of Health and Human Services Hospitals Medicare Medicare 59

YouCompli

SEPTEMBER 13, 2023

Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic.

US Department of Health and Human Services 52

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

Healthcare IT Today

AUGUST 28, 2023

Stephen Sofoul, SVP, Data & Decision Science Services at MultiPlan A critical challenge lies in the shortage of experienced financial analysts or data analysts capable of effectively analyzing the wealth of information that the healthcare industry holds. However, with healthcare being ever-evolving our regulations are also ever evolving.

US Department of Health and Human Services 110

US Department of Health and Human Services Telemedicine Hospitals Compliance 110

Healthcare IT News - Telehealth

AUGUST 11, 2021

Department of Health and Human Services works to ensure the integrity of federal healthcare programs and to safeguard the health and welfare of those programs' beneficiaries. And I think it's important for us to recognize that we don't know a whole lot right now.

US Department of Health and Human Services 158

US Department of Health and Human Services Fraud Medicare Medicare 158

Med-Net Compliance

JUNE 22, 2022

Investigation of the case was conducted by the US Department of Veterans Affairs-Office of Inspector General (VA-OIG), VA Police Detroit and the Medicare Fraud Strike Force (MFSF) partners, a partnership among the Criminal Division, US Attorney’s Offices, and US Health and Human Services-Office of Inspector General (HHS-OIG).

COVID-19 Vaccine 59

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

YouCompli

DECEMBER 7, 2022

Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.

Fraud 52

Fraud US Department of Health and Human Services Compliance Medicaid 52

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Healthcare It News

APRIL 28, 2023

Department of Health & Human Services and the Office of the National Coordinator for Health IT offered some updates on how the agencies are working together and with others to help shape a "digital healthcare system of the future" that works for everyone. " And it's not just within HHS.

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US Department of Health and Human Services Medicaid Medicaid Governance 235

YouCompli

NOVEMBER 18, 2023

Most of us have had the experience of preparing for an important conversation or interaction, only to leave it feeling defeated, misunderstood, and not even really heard. In this article, we will examine four essential listening skills that help compliance officers be more effective within their organizations.

Compliance Officers 52

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

Healthcare IT News - Telehealth

SEPTEMBER 28, 2022

Accountable Care Compliance & Legal Government & Policy Telehealth Workforce Healthcare organizations must urge the Senate to pass critical telehealth legislation, and enact at least a two-year extension of the important PHE-era policies while working toward a permanent solution. In January 2020, then-Secretary of the U.S.

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COVID-19 Public Health US Department of Health and Human Services Medicare 124

AIHC

NOVEMBER 15, 2022

Written by Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS The Federal Hospital Price Transparency Rule helps Americans know the cost of a hospital item or service before receiving it. Compliance is mandatory. So, exactly what is this all about? Consequences of Noncompliance?

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

Healthcare IT News - Telehealth

SEPTEMBER 27, 2022

Accountable Care Compliance & Legal Government & Policy Telehealth Workforce Healthcare organizations must urge the Senate to pass critical telehealth legislation, and enact at least a two-year extension of the important PHE-era policies while working toward a permanent solution. In January 2020, then-Secretary of the U.S.

COVID-19 112

COVID-19 Public Health US Department of Health and Human Services Medicare 112

YouCompli

NOVEMBER 16, 2022

Strengthen your listening skills to improve your effectiveness as a healthcare compliance officer. Sharon Parsley, JD, MBA, CHC, CHRC’s writes a monthly series on compliance officer effectiveness for the YouCompli blog. According to betterup.com, discriminative listening is a skill all humans are born with.

US Department of Health and Human Services 52

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

Hall Render

AUGUST 19, 2022

Amazon to offer behavioral health services through Ginger partnership. CDC, amid criticism for COVID-19 response, plans reorganization as public health threats grow. House approves sweeping climate, tax, health care package. Joint Commission’s New Accreditation Standards Tackle Health Disparities. CALIFORNIA.

COVID-19 40

COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Hall Render

MARCH 31, 2023

in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? What happens if it disappears?

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

Hall Render

MAY 5, 2023

acquisition of Oak Street Health to expand primary care footprint Did Hospitals Violate EMTALA by Failing to Provide Abortion Care? acquisition of Oak Street Health to expand primary care footprint Did Hospitals Violate EMTALA by Failing to Provide Abortion Care?

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nurses Hospitals 40

Hall Render

MARCH 22, 2024

NATIONAL 79 percent have positive outlook for senior living and care: NIC 12 key legal issues impacting health systems AHA: 94% of hospitals financially impacted by Change Healthcare’s cyberattack A conversation about the HHS plan on AI in health care A new kind of hospital is coming to rural America.

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

JANUARY 28, 2022

FDA halts use of antibody drugs that don’t work vs. omicron. Where Hospital Price Transparency Compliance Is Lagging. Medicare posts key nursing home staffing info for consumers. Safety-net hospitals face the worst of the US’ nursing shortage. State health officer discusses Alabama’s COVID-19 peak.

Nursing Homes 40

Nursing Homes COVID-19 US Department of Health and Human Services Nurses 40

Hall Render

SEPTEMBER 29, 2023

million patients Senate committee advances bill cutting hospital facility fees What Joint Commission, NQF’s affiliation means for hospitals Which health systems teamed up with Amazon, Google + Microsoft ALABAMA Alabama gets $3.6M in Stark law self disclosures: 3 things to know CMS’ staffing proposal will cost nursing homes $6.8B

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

JULY 21, 2023

Vincent’s nurse, physician communication among top in Alabama UAB Hospital receives millions in state funds to expand ED 988 one year later: More needed to expand mental health in Alabama communities of color Alabama lawmakers hear from Pickens County on effort to re-open medical center ALASKA City OKs $8.1M Million St. Million St.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Drug & Device Law

DECEMBER 29, 2023

Executive Health Resources, Inc. , 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. Executive Health Resources, Inc. , United States Department of Health and Human Services , 58 F.4th

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