MRO Compliance

JUNE 1, 2022

Information You Need to Know about a HEDIS Audit from Revenue Cycle Experts. Each year HEDIS rating criteria is updated, meaning your organization needs to stay up-to-date on the latest news and trends for HEDIS compliance audits. This information becomes increasingly valuable to providers during payer contract negotiations.”

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MedTrainer

DECEMBER 7, 2023

State-specific governing bodies, such as the Bureau of Facility Standards , provide oversight with certain standards, adding a layer of complexity to successfully managing healthcare compliance in Idaho. Continue reading this overview for key aspects of healthcare compliance specific to the state of Idaho.

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MedTrainer

NOVEMBER 29, 2023

With its distinctive legal environment, Louisiana poses a few unique healthcare compliance challenges that differ from other states. Managing healthcare compliance in Louisiana successfully means that providers and organizations can skillfully navigate their state-specific regulatory framework.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

As is the case with every state, there are distinctive challenges in the management of healthcare compliance in North Carolina, shaped by its own unique regulations. Keep scrolling for a summary of the crucial elements of healthcare compliance relevant to North Carolina.

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Compliance Licensing Telemedicine Medicaid 52

MedTrainer

NOVEMBER 29, 2023

One critical aspect of managing healthcare compliance in South Carolina is the adherence to both federal laws and state-specific regulations, including those pertaining to telehealth, which has seen significant growth in the state. Read on for vital information about maintaining healthcare compliance in South Carolina.

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MedTrainer

DECEMBER 7, 2023

To sail smoothly through the complex rules and requirements, you need a deep knowledge of the most essential aspects of healthcare compliance in Maine. A successful compliance program involves adaptability, comprehensive planning, and insight into key compliance factors, including credentialing requirements.

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MedTrainer

NOVEMBER 30, 2023

Like other regions in the United States, Wisconsin is characterized by its unique blend of rules and mandates that govern healthcare compliance within the state. This post sheds light on certain aspects of healthcare compliance in Wisconsin, with tips for effectively managing your healthcare organization.

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MedTrainer

NOVEMBER 20, 2023

Similar to other states, maintaining healthcare compliance in Florida State involves meeting state-specific regulations and requirements. This post offers an overview of must-know compliance requirements for Florida. While many states have rules that prohibit the storage of Medicaid data outside the U.S.,

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Compliance Licensing Regulatory Compliance Medicaid 52

MedTrainer

NOVEMBER 17, 2023

Managing healthcare compliance in Illinois requires healthcare organizations and professionals to stay informed about state-specific regulations while also adhering to federal healthcare compliance standards. Medical licensing is provided by the Illinois Department of Financial and Professional Regulation.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 28, 2023

Healthcare providers, organizations, and compliance officers in Michigan State need to be aware of their state-specific laws and regulations in order to navigate compliance successfully. This article serves as a quick-reference guide for maintaining healthcare compliance in Michigan State.

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MedTrainer

DECEMBER 7, 2023

Healthcare compliance in New Mexico mirrors the state’s diverse culture, with unique regulations that differ from other states, such as credentialing documentation requirements for managed care organizations. New Mexico’s parity law requires insurers to cover telemedicine services to the same extent as in-person services.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 28, 2023

Healthcare compliance in Arizona involves a unique set of rules and standards that impact compliance management for all medical organizations. This overview highlights important aspects that are particularly relevant to healthcare compliance in Arizona.

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Compliance Licensing Public Health Medicaid 52

MedTrainer

DECEMBER 7, 2023

All healthcare organizations, along with their providers and compliance officers, must understand the requirements of each regulatory state agency that provides oversight. Robust, flexible, and reliable compliance programs must be developed to maintain compliance in Hawaii.

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MedTrainer

MARCH 28, 2024

Healthcare compliance. Just as perplexing is who is responsible for compliance in healthcare organizations. The answer has as many layers as the definition of compliance itself. The answer has as many layers as the definition of compliance itself. Who in the Organization Is Responsible for Healthcare Compliance?

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MedTrainer

NOVEMBER 28, 2023

Managing healthcare compliance in New Jersey means adhering to a unique set of rules and standards that pose certain challenges for management teams. New Jersey’s healthcare organizations are encouraged to design thorough systems for tracking and understanding these regulations and make updates to their compliance programs as needed.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 4, 2023

Managing healthcare compliance in Mississippi effectively means adapting to the state’s specific regulations, and having the right systems in place to stay on track. To successfully oversee healthcare compliance in Mississippi, organizations need to develop efficient methods for tracking regulatory updates.

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Compliance Telemedicine Licensing Public Health 52

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

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Medicaid Medicaid Licensing Medical Billing Outsourcing 52

MedTrainer

DECEMBER 7, 2023

Ensuring healthcare compliance in New Hampshire involves maintaining both federal and state guidelines, while providing quality patient care. New Hampshire healthcare organizations must develop dynamic compliance programs to keep up with evolving regulations.

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Compliance Licensing Public Health Medicaid 52

MedTrainer

NOVEMBER 29, 2023

The landscape of healthcare compliance in Tennessee is marked by distinct rules and regulations that must be adhered to by organizations across the state. This article serves as a comprehensive primer, highlighting the key elements of healthcare compliance that are specific to Tennessee. TennCare is Tennessee’s managed Medicaid agency.

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Compliance Licensing HIPAA Medicaid 52

MedTrainer

NOVEMBER 20, 2023

Managing healthcare compliance in Texas is nuanced and challenging. For successful compliance management in Texas, healthcare organizations need to develop a strong system for tracking and interpreting regulatory changes, and promptly adapt to these modifications.

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Compliance Licensing Public Health Governance 52

MedTrainer

NOVEMBER 17, 2023

This model involves specific regulations and agreements with Medicare and Medicaid, impacting how healthcare providers in the state bill for services and receive payments. Both the Maryland Department of Health – Behavioral Health Administration and the Board of Physicians license medical and mental/behavioral health providers.

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Compliance Licensing Hospitals Health Insurance 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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MedTrainer

NOVEMBER 14, 2023

When it comes to healthcare delivery, compliance is not just a matter of ticking boxes; it’s the backbone of patient trust and safety. In this blog post, we’ll explore the many reasons why healthcare compliance isn’t just important — it’s vital. What Is Healthcare Compliance?

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Compliance HIPAA Governance Medicare 52

MedTrainer

NOVEMBER 30, 2023

Minnesota, distinct from other states, carries a unique landscape of regulations and standards that govern its healthcare compliance. Navigating and managing compliance in Minnesota can certainly be a challenge for providers and facilities. Juggling top-notch patient services and the state’s compliance requirements is no easy task.

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Compliance Licensing Public Health Governance 52

MedTrainer

NOVEMBER 17, 2023

Just like all states, Pennsylvania has its own distinct healthcare regulations and requirements that compliance teams need to consider. Read on for insights into the essential aspects of healthcare compliance in Pennsylvania. The Pennsylvania State Board of Medicine is responsible for regulating medical provider licensing requirements.

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Compliance Licensing Health Outcomes 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

Medisys Compliance

APRIL 19, 2023

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

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Medicaid Medicaid Medical Billing Outsourcing Licensing 52

MedTrainer

NOVEMBER 14, 2023

Healthcare compliance regulations can vary significantly from one state to another, so managing healthcare compliance in Virginia may be different compared to other states. Regulations Unique to Virginia To meet the standards of healthcare compliance in Virginia, there are a few additional regulations.

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Compliance Licensing Governance Hospitals 52

MedTrainer

JANUARY 12, 2024

Healthcare compliance is serious business for regulators. In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. What is Healthcare Compliance? Who Regulates Healthcare Compliance?

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Compliance Fraud Medicaid Medicaid 52

MedTrainer

NOVEMBER 29, 2023

A unique set of rules and standards can pose a unique set of challenges for overseeing healthcare compliance in Indiana. Just as in other states, Indiana health professionals and groups must have a firm grasp of state-specific regulations in order to effectively manage their healthcare compliance.

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Provider Trust

SEPTEMBER 29, 2022

A 49-year-old Brownsville, TX man named Fernando Mendez was taken into custody in early September after being charged with defrauding Medicaid. Mendez, who was a physician assistant at CCI Therapy Counseling Centers International, was working with a suspended medical license. How Often Should You Verify Employee Licenses?

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Licensing Fraud Medicaid Medicaid 52

MedTrainer

NOVEMBER 5, 2023

Colorado, like other states in the United States, has its own set of regulations and requirements that make managing healthcare compliance in Colorado tricky. To effectively manage compliance, healthcare organizations must establish a robust system for monitoring and interpreting these changes and swiftly implement necessary adjustments.

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Compliance Licensing Informed Consent Public Health 52

MedTrainer

DECEMBER 4, 2023

Effective management of healthcare compliance in Nebraska involves careful planning and adaptability. As the state’s healthcare regulations are updated, it’s vital for organizations to maintain efficient compliance programs. Healthcare compliance means remaining current with the state’s unique regulatory requirements.

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Compliance Licensing Nursing Homes Nurses 52

MedTrainer

DECEMBER 4, 2023

Healthcare compliance in North Dakota differs in several ways from other states, primarily influenced by the state’s rural character and unique healthcare priorities. Additionally, the state’s approach to Medicaid expansion involves unique waivers, impacting eligibility criteria and cost-sharing provisions.

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Compliance Licensing Health Outcomes Medicaid 52

MedTrainer

NOVEMBER 30, 2023

To manage healthcare compliance in Alabama successfully, providers and compliance officers need to know the ins-and-outs of state-specific regulations. While tricky to navigate, staying up to date with compliance requirements and standards can make the process more manageable.

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Compliance Compliance Officers Public Health Licensing 52

MedTrainer

DECEMBER 7, 2023

Effective management of healthcare compliance in West Virginia requires consistent adherence to both federal and state agency standards. To steer clear of legal or financial repercussions as a result of non-compliance, it’s crucial for organizations in West Virginia to establish robust compliance programs.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

SEPTEMBER 8, 2023

Maintaining compliance with healthcare regulations and standards isn’t just a legal requirement; it’s a crucial element in upholding patient safety, data security, and the overall integrity of healthcare practices. Hear more on compliance essentials from a panel of expert healthcare surveyors. Why Is Healthcare Compliance Important?

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