MedTrainer

OCTOBER 16, 2023

This is the essence of corporate compliance in healthcare. Just as every piece of the puzzle must fit perfectly, every compliance element in healthcare needs precise integration to ensure seamless, ethical, and effective operations. Dive with us as we explore the complexities and necessities of compliance in the healthcare sector.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Medicaid 52

Healthcare IT Today

JANUARY 2, 2024

The following is a guest article by Marlena Herrera, Director at Protegrity Healthcare organizations are becoming more lucrative targets for hackers, as their data is rich with extremely sensitive information and is often susceptible to vulnerabilities.

Compliance 69

Compliance US Department of Health and Human Services HIPAA Health Insurance 69

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.

US Department of Health and Human Services 81

US Department of Health and Human Services HIPAA Compliance Medicaid 81

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

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. Training employees on compliance issues.

Compliance Officers 52

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

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. This includes recommending compliance programs or trainings for staff.

US Department of Health and Human Services 52

US Department of Health and Human Services Nursing Homes COVID-19 Medicare 52

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. This includes recommending compliance programs or trainings for staff.

US Department of Health and Human Services 52

US Department of Health and Human Services COVID-19 Nursing Homes Medicare 52

Compliancy Group

JANUARY 17, 2024

The OIG Work Plan, sometimes referred to as “the Work Plan” or “the Plan,” is an essential tool in securing and maintaining healthcare regulatory compliance for patient safety, privacy, and quality care. The OIG Compliance Work Plan identifies significant risks and areas that require attention within the healthcare system.

US Department of Health and Human Services 52

US Department of Health and Human Services Compliance Regulatory Compliance Regulations Compliance 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 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

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

Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. A federal district court judge will determine any sentence after considering the US Sentencing Guidelines and other statutory factors.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

Med-Net Compliance

OCTOBER 19, 2022

The settlement resolves allegations that between 2013 and 2020, the company paid remuneration to its home health medical directors in Oklahoma and Texas for the purpose of inducing referrals of Medicare and TRICARE home health patients. The corporate officers were previously the CEO and COO of the company.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Medicaid 59

Med-Net Compliance

AUGUST 18, 2022

An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.? Ensure that your policies are reviewed at least annually and updated when new information becomes available.

Nursing Homes 59

Nursing Homes US Department of Health and Human Services Nurses Medicare 59

Med-Net Compliance

NOVEMBER 8, 2022

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections). OIG inspectors recommended the facility develop a process to collect this data and post the information as required.

Nursing Homes 59

Nursing Homes Nurses US Department of Health and Human Services Licensing 59

Healthcare Compliance Blog

JUNE 9, 2022

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. HHS-OIG will continue to work with the US Attorney’s Office to ensure the integrity of the Medicare Trust Fund.”.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Overpayments 59

Total HIPAA

JANUARY 18, 2022

HIPAA breaches involving fewer than 500 individuals which occurred during 2021 must be reported to the US Department of Health and Human Services (HHS) by Tuesday, March 1, 2022. Here are a few examples from the HHS website: A municipal social service agency disclosed PHI while processing Medicaid applications.

HIPAA 92

HIPAA US Department of Health and Human Services Compliance Medicaid 92

Verisys

JUNE 13, 2023

A big thanks to our compliance team, who monitors state, federal, and international updates. It withdraws the regulations issued in the interim final rule published November 5, 2021 in “Omnibus COVID-19 Health Care Staff Vaccination”. Also the removal of obsolete and irrelevant information. (§302)

COVID-19 Vaccine 52

COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

Med-Net Compliance

OCTOBER 26, 2022

The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced that they will be enhancing their focus on potentially preventable hospitalizations of Medicare-eligible skilled nursing facility (SNF) residents. and 42 CFR § 483.25).

Nursing Homes 59

Nursing Homes Nurses US Department of Health and Human Services Hospitals 59

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

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

Verisys

JANUARY 6, 2022

Federal payments for healthcare services account for 28% of all healthcare spending in the United States. Payments from Medicare, Medicaid, TRICARE, CHIP, and other federal programs are a significant source of funds for nearly every healthcare organization and provider. There are two types of OIG exclusions : permissive and mandatory.

US Department of Health and Human Services 52

US Department of Health and Human Services Fraud Medicaid Medicaid 52

C&M Health Law

JANUARY 20, 2023

This builds on the HIPAA Transactions Rule standards for financial and administrative transactions among health care providers and health plans and aligns with Department of Health and Human Services (HHS) interoperability regulations.

HIPAA 52

HIPAA US Department of Health and Human Services Compliance Health Insurance 52

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

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.

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US Department of Health and Human Services Fraud Medicare Medicare 154

Verisys

JANUARY 19, 2022

Due to the complex nature of medical credentialing, it requires coordination between several disparate departments within an organization. According to recent surveys of major metropolitan hospitals , departments that typically share the responsibility for credentialing include: The Compliance Office. Human Resources.

US Department of Health and Human Services 52

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

Verisys

AUGUST 14, 2023

A big thanks to our compliance team, who monitors state, federal, and international updates. See below for changes from several states introducing legislation. The listening sessions will be held on Tuesday, September 12, 2023, and Wednesday, September 13, 2023, from 9 a.m. to 5:30 p.m.

US Department of Health and Human Services 52

US Department of Health and Human Services Licensing Telemedicine Medicare 52

Healthcare IT Today

JANUARY 10, 2024

As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. Jason Considine, Chief Commercial Officer at Experian Health Staffing shortages will continue to be a major pain point for providers in 2024 and have a direct impact on their bottom line.

US Department of Health and Human Services 115

US Department of Health and Human Services Nurses Hospitals Telemedicine 115

Total HIPAA

FEBRUARY 23, 2023

Did you know that any HIPAA security breaches affecting less than 500 individuals in 2022 must be reported to the US Department of Health and Human Services by March 1, 2023? Here are a few examples from the HHS website: A municipal social service agency disclosed PHI while processing Medicaid applications.

US Department of Health and Human Services 52

US Department of Health and Human Services HIPAA Compliance Medicaid 52

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

Verisys

JANUARY 27, 2022

COVID has impacted every aspect of daily life, and these changes have affected people’s mental health, making telehealth services for behavioral health more important than ever. Others may become susceptible to mental health issues, such as depression or anxiety. The use of telemedicine in the U.S.

US Department of Health and Human Services 52

US Department of Health and Human Services Telemedicine Licensing Informed Consent 52

Hall Render

DECEMBER 29, 2023

NATIONAL 4 largest healthcare data breaches of 2023 Anesthesia practices sue CMS over reimbursement method Antitrust enforcements hit a high in 2022, with health deals impacted ASCs face leadership exodus CMS floats appeals process over observational stays CMS proposes additional Medicare appeals processes FTC eyes healthcare mergers, report shows (..)

Nursing Homes 40

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

Hall Render

FEBRUARY 16, 2024

CALIFORNIA 8 ASCs opening in Florida, California and New York A bankrupt California hospital left a health care desert. CALIFORNIA 8 ASCs opening in Florida, California and New York A bankrupt California hospital left a health care desert.

US Department of Health and Human Services 40

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

Provider Trust

JANUARY 26, 2022

Luckily for all us, there’s a spectrum–and it was created with visibility and safety in mind. Department of Justice (DOJ), the U.S. And when patient care and reimbursements are on the line, even one bad actor can put an entire organization’s reputation in jeopardy. How the OIG Finds & Prosecutes Healthcare Fraud.

Fraud 52

Fraud US Department of Health and Human Services Medicaid Medicaid 52

Medval Compliance Blog

MARCH 10, 2022

by Frank Fairchok, Vice President of Medicare Reporting Services. Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. 0938-AT85 – Medicare Secondary Payer and Future Medicals (CMS-6047). 0938-AT85 – Medicare Secondary Payer and Future Medicals (CMS-6047).

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Hall Render

JANUARY 27, 2023

NATIONAL Amazon launches $5-a-month unlimited prescription plan CMS begins publicizing disputed nursing home deficiencies CMS Readies Nursing Home Staffing Mandate Proposal, Reviews Study Recommendations Healthcare workers are unhappy with their pay Kroger Health launches clinical trial site network Local anesthetic drug supply: 132 in shortage, 13 (..)

US Department of Health and Human Services 40

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