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. Below is information on what your healthcare organization should know about HEDIS in 2022.

Medicare 130

Medicare Medicare Compliance Medicaid 130

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?

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

DECEMBER 4, 2023

Responsible healthcare providers and compliance professionals in each state of the United States must follow specific regulations, and achieving healthcare compliance in Kentucky is no exception. Regulations Unique to Kentucky To meet the standards of healthcare compliance in Kentucky , there are a few additional regulations.

Compliance 52

Compliance Licensing Medicaid Medicaid 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?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Provider Trust

MAY 26, 2023

Thursday, June 22, 2023 | 12-1pm CST Join us for an information session where Donna Thiel, Chief Compliance Officer at ProviderTrust, will share her expertise and valuable feedback from the 2023 HCCA Compliance Institute.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

MedTrainer

APRIL 22, 2024

Several federal agencies highly recommend having a healthcare compliance committee — the key is to make the committee helpful, not just a regulatory checkbox. Compliance committees vary based on the size of the organization, the care setting, and the committee’s charter. What is a Healthcare Compliance Committee?

Compliance 52

Compliance Compliance Officers Governance Medicaid 52

MedTrainer

FEBRUARY 7, 2024

The complex world of healthcare compliance demands a clear understanding of responsibilities. For those new to the role of compliance officer, the question often arises: “Who is responsible for compliance in healthcare?” Who is Responsible for Compliance in Healthcare?

Compliance 52

Compliance Compliance Officers Health Insurance Medicaid 52

Compliancy Group

MARCH 22, 2024

As a compliance officer or critical decision-maker, you can help your healthcare organization avoid exclusion from this valuable program by creating a comprehensive compliance program and using software to streamline your compliance processes. Remaining in good standing with Medicare has several advantages.

Medicare 52

Medicare Medicare Compliance Compliance Officers 52

American Medical Compliance

JUNE 19, 2023

Several states have recently approved the extension of postpartum Medicaid coverage beyond the usual two-month period. By providing extended Medicaid coverage, states are taking a proactive approach to safeguarding the well-being of mothers during this vulnerable period. More States OK Extended Postpartum Medicaid.

Medicaid 52

Medicaid Medicaid Compliance 52

Compliancy Group

MARCH 19, 2024

Hospitals and private practices aren’t the only enterprises with compliance obligations within this sector. Regulatory compliance in healthcare ensures quality care for patients. In this blog, we’ll outline the fundamentals and importance of regulatory compliance in healthcare in the U.S. name, phone number).

Regulatory Compliance 52

Regulatory Compliance Compliance US Department of Health and Human Services ACA 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?

Compliance 52

Compliance Fraud Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

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.

Compliance 52

Compliance Medicaid Medicaid Licensing 52

Compliancy Group

JANUARY 3, 2024

This article discusses the issues related to medical billing compliance policy and the steps for providers to maintain financial integrity and adherence to all requirements. Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

MedTrainer

JANUARY 22, 2024

offers insight into healthcare policy changes on the horizon and the predicted impact on compliance. In The Impact of Health Policy on Your Compliance Strategy, Hira talks about the macro trends in healthcare that could lead to policy change — for example the focus on cost savings and outcome improvements.

Compliance 52

Compliance Medicare Medicare Medicaid 52

MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

MedTrainer

NOVEMBER 27, 2023

What does healthcare compliance in Georgia look like? Like all states, Georgia has its own distinct rules and regulations that compliance management teams must follow. Keep reading for resources, tips, and regulations unique to healthcare compliance in Georgia. These requirements are unique to Georgia.

Compliance 52

Compliance Licensing Medicaid 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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

JANUARY 30, 2024

Healthcare compliance is a critical part of any organization’s business model. The professionals who manage compliance are the front lines of preventing medical errors, deterring fraud, and staying in good standing with federal payers like the Centers for Medicare and Medicaid Services (CMS).

Compliance 52

Compliance Compliance Officers Fraud Medicaid 52

MedTrainer

MARCH 22, 2024

Today’s healthcare workers expect more from a compliance training program. For the administrators, compliance officers, and HR professionals tasked with crafting such programs, the challenge is finding a balance between what is legally required and what is practical for their already stretched staff.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 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.

Compliance 52

Compliance Licensing Health Outcomes 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.

Compliance 52

Compliance Licensing Public Health Compliance Officers 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.

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

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.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 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.

Compliance 52

Compliance Telemedicine Licensing Public Health 52

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?

Compliance 52

Compliance HIPAA Governance Medicare 52

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.

Compliance 52

Compliance Licensing Compliance Officers Medicaid 52

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

AIHC

JANUARY 5, 2023

Learn about the 7 steps to Medicare Compliance Medicare is federally regulated and requires healthcare providers to ensure that they comply with the many requirements before being eligible for reimbursement. Applying for Medicare compliance can be a daunting task for healthcare providers. What does this mean?

Medicare 59

Medicare Medicare Compliance Medicaid 59

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.

Compliance 52

Compliance Licensing Medicaid 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.

Compliance 52

Compliance Compliance Officers Licensing Medicaid 52

YouCompli

DECEMBER 19, 2023

Last month, the Office of Inspector General (OIG) published a new, user-friendly, 91-page General Compliance Program Guidance (GCPG). Exclusions (page 26) : OIG recommends that any entity participating in the federal Medicaid program should check the state Medicaid program exclusion list for each applicable state.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 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).

Medicaid 52

Medicaid Medicaid Medical Billing Outsourcing Licensing 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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

JANUARY 12, 2024

HIPAA compliance is a fundamental aspect of healthcare operations in the United States, playing a pivotal role in safeguarding patient privacy and data security. How does HIPAA compliance affect healthcare facilities? What is Healthcare Compliance?

HIPAA 52

HIPAA Compliance Health Insurance Hospitals 52