YouCompli

FEBRUARY 4, 2025

The HHS OIG recently issued its first Industry Segment-Specific Compliance Program Guidance, or ICPG , with many more expected. This first ICPG covers Skilled Nursing Facilities and Nursing Facilities. The OIG expects nursing facilities to be proactive in their oversight of billing compliance. CJ Wolf, MD, M.Ed.

Nurses 52

Nurses Overpayment Overpayments Compliance 52

Healthcare IT News - Telehealth

MARCH 18, 2020

The HHS Office for Civil Rights announced on Tuesday that during the coronavirus pandemic it will use discretion when enforcing HIPAA-compliance for telehealth communications tools. WHY IT MATTERS. and Google G Suite Hangouts Meet. THE LARGER TREND. ON THE RECORD.

COVID-19 217

COVID-19 HIPAA Nursing Homes Medicare 217

Hall Render

JANUARY 29, 2025

The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. CMSs Focus on Surveys and Fraud Identification The CMS Memo highlights the dual purpose of hospice surveys: Ensuring Compliance : Evaluating whether hospice providers meet CoPs.

Fraud 80

Fraud Medicare Medicare Compliance 80

AIHC

DECEMBER 27, 2024

Baptist Medical Center, the court upheld a hospitals decision to prevent male nurses from being assigned to labor and delivery units. 10] Further, the National Council of State Boards of Nursing (NCSBN) states that Sexual boundary violations result in significant and enduring harm to patients. [11] 8] In Backus v. April 1, 2024.

Informed Consent 98

Informed Consent Bioethics ADA Medical Personnel 98

American Medical Compliance

FEBRUARY 19, 2025

American Medical Compliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education to physicians. American Medical Compliance designates this activity for a maximum of 2.25 To become certified, please visit us at: American Medical Compliance (AMC).

Nurses 52

Nurses Compliance Medicaid Medicaid 52

HIT Consultant

AUGUST 3, 2022

As a Board-Certified Internist and Geriatrician with over 35 years of providing care in nursing facilities, this sentiment has guided me throughout my career. Our nursing facility industry is about to crumble. The nursing industry is being torn apart by the convergence of several major currents: 1. million to 1.35 million to 1.35

Nursing Homes 98

Nursing Homes Nurses COVID-19 Medicaid 98

Healthcare Compliance Blog

FEBRUARY 2, 2022

A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursing home residents, but which were never provided. Many of the residents for whom the optician submitted claims were deceased, and he never visited the nursing homes on the dates of the those claims.

Nursing Homes 59

Nursing Homes Fraud Medicaid Medicaid 59

Healthcare Blog

JANUARY 19, 2025

One key offering that is entirely unique to CAHs is the swing bed program, which allows hospitals to use the same beds for both acute care and skilled nursing services. For patients, swing beds reduce the stress and logistical challenges of being transferred to a separate skilled nursing facility.

Medicare 52

Medicare Medicare Compliance Nurses 52

Healthcare Law Blog

OCTOBER 27, 2022

On October 21, 2022, the Centers for Medicare and Medicaid Services (CMS) announced changes to its Special Focus Facility (SFF) program, including new steps to address nursing home facilities that fail to graduate from the SFF program in a timely manner, or “yo-yo” back into non-compliance after graduating from the SFF program.

Nursing Homes 96

Nursing Homes Medicaid Medicaid Nurses 96

Verisys

MARCH 6, 2025

Provider credentialing is the formal process by which healthcare organizations verify that healthcare professionalssuch as physicians , nurses , and allied health practitionersmeet the necessary qualifications required to provide care. Thats where provider credentialing comes in.

Licensing 52

Licensing Compliance Nurses Malpractice 52

Verisys

APRIL 3, 2025

Faster onboarding, fewer healthcare compliance risks, and more time spent on patient carenot paperwork. Think about a hospital credentialing service onboarding a traveling nurse in the middle of flu season. With manual nurse credentialing, the process could drag on for weeks, delaying much-needed care.

Licensing 52

Licensing Malpractice Compliance Nurses 52

MedTrainer

AUGUST 8, 2024

In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Why Additional Training Is Required for Medicare-Enrolled Providers Training helps providers understand and adhere to Medicare’s complex regulations and guidelines, essential for maintaining compliance.

Medicare 93

Medicare Medicare Compliance Medicaid 93

Healthcare IT News - Telehealth

AUGUST 30, 2021

In doing so, Trinity also hoped to receive readmission incentives from the Centers for Medicare and Medicaid Services, avoid penalties, and reduce costs as it transitioned to value-based care reimbursement. "Nurse satisfaction has improved, as well, due to a decrease in after-hours visits with nurses who had already worked a full day."

Patient Satisfaction 195

Patient Satisfaction Nurses Medicare Medicare 195

Health Law RX

SEPTEMBER 14, 2021

Medicare and Medicaid certified facilities will be required to ensure that their employees are vaccinated for COVID-19, the Centers for Medicare & Medicaid Services (CMS) announced on September 9, 2021. The Interim Final Rule will apply to any healthcare facility receiving Medicare or Medicaid reimbursement. The OSHA ETS.

Medicaid 75

Medicaid Medicaid Medicare Medicare 75

Hall Render

SEPTEMBER 22, 2023

In 2023, nursing homes have seen increased citations by surveyors for noncompliance tied to their pre-dispute, binding agreements for binding arbitration with their residents. When used appropriately, these agreements can streamline conflict resolution processes, but operators must tread carefully to ensure compliance with the regulations.

Nursing Homes 73

Nursing Homes Nurses Compliance Medicaid 73

Hall Render

FEBRUARY 17, 2025

According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program.

Medicare 89

Medicare Medicare Nursing Homes Medicaid 89

Healthcare Blog

AUGUST 23, 2023

It is critical for an organization to have strategies for promoting ethical behavior in healthcare compliance. Strategies Healthcare Organizations Can Use to Promote Ethical Behavior in Compliance Ensuring ethical practices in healthcare compliance is essential to corporate health and the integrity of your organization.

Compliance 73

Compliance Nurses Regulatory Compliance Medicaid 73

Healthcare IT News - Telehealth

APRIL 24, 2020

The Alliance for Integrated Care of New York (AICNY) oversees the healthcare needs of roughly 6,200 dually eligible Medicare and Medicaid beneficiaries with intellectual and developmental disabilities (IDD). If warranted, the nurse will recommend an assessment by telemedicine triage with the telemedicine triage provider, StationMD.”

Telemedicine 198

Telemedicine COVID-19 Medicaid Medicaid 198

HIT Consultant

DECEMBER 23, 2024

Enhancing Provider Education on SDOH Programs Nurses, doctors, and pharmacists are among the most trusted professionals in the U.S., Building privacy-respecting data-sharing frameworks to ensure compliance with HIPAA and other regulations can increase beneficiary trust in MA plans.

Health Outcomes 97

Health Outcomes Medicare Medicare Patient Satisfaction 97

Verisys

MARCH 6, 2025

Healthcare executives and compliance officers must consistently update and verify provider data to enhance patient care, adhere to regulatory standards, and streamline administrative tasks. These small discrepancies can cause major disruptions down the line, from billing issues to compliance violations. What Is Provider Data Quality?

Compliance 52

Compliance Licensing Doctors Malpractice 52

Med-Net Compliance

NOVEMBER 2, 2022

Massachusetts Attorney General Maura Healey announced that her office’s Medicaid Fraud Division recovered more than $71 million during the most recent federal fiscal year, which ended on September 30. The AG’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state’s Medicaid program, MassHealth.

Fraud 59

Fraud Medicaid Medicaid Compliance 59

Healthicity

NOVEMBER 1, 2022

Medicaid Fraud Control Units.

Fraud 98

Fraud Nurses Medicare Medicare 98

Healthcare Compliance Blog

JANUARY 25, 2022

A Missouri woman who had previously pled guilty to Medicare and Medicaid fraud was sentenced in Federal Court to three years imprisonment and ordered to pay $7,620,779 in restitution. The DME companies would then submit the reimbursement claims to Medicare and Medicaid. General Legal Duties and Antitrust Laws.

Fraud 59

Fraud Medicaid Medicaid Medicare 59

Hall Render

NOVEMBER 25, 2024

Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

Med-Net Compliance

OCTOBER 27, 2022

According to court documents and evidence presented at trial, the psychologist caused the submission of fraudulent Medicare claims from July 2016 through June 2019 for psychotherapy services purportedly provided to nursing home residents in Chicago and surrounding areas.

Nursing Homes 59

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

Healthcare IT News - Telehealth

SEPTEMBER 15, 2021

Over the years, while digital technology was quickly advancing, telehealth had a relatively low adoption rate due to poor reimbursement rates and regulatory challenges when it came to patient privacy and HIPAA compliance. This means patients can receive care wherever they are – at home, nursing home, assisted living, etc.

Telemedicine 195

Telemedicine COVID-19 Medicare Medicare 195

Total Medical Compliance Resources

APRIL 16, 2025

Several regulatory agencies, including the Joint Commission and Centers for Medicare and Medicaid mandate documentation. The Center for Disease Control (CDC) and the Association of Perioperative Registered Nurses (AORN) have steps to follow in the event a spore testing is positive.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

MedTrainer

JANUARY 30, 2024

What types of healthcare facilities are required by the government to have a compliance program? In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them.

Governance 52

Governance Compliance Nursing Homes Medicaid 52

Med-Net Compliance

AUGUST 16, 2022

Five individuals and two for-profit skilled nursing facilities (SNFs) in Pennsylvania were indicted on charges of conspiracy to defraud the United States and related healthcare fraud charges. Billing Medicare or Medicaid for services that were not provided is fraudulent activity that is often punishable by fines and imprisonment.

Fraud 59

Fraud Nurses Medicaid Medicaid 59

MedTrainer

JULY 29, 2024

Healthcare compliance is complicated for organizations of any size. However, the complexities grow exponentially for large or enterprise organizations with hundreds or thousands of employees who must complete and pass rigorous compliance training. What Is Corporate Compliance Training?

Compliance 52

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

Healthcare IT Today

DECEMBER 30, 2024

This is where nursing leaders must step in, bridging the gap between clinical excellence and strategic integration. This API-first approach will be driven by health plans needing to perform with Medicare Advantage and managed Medicaid. MA and Medicaid plans will be working overtime to harvest data and influence rating outcomes.

US Department of Health and Human Services 88

US Department of Health and Human Services Nurses Medicare Medicare 88

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

Verisys

APRIL 3, 2025

However, the process itself can be complicated and time-consumingand when things go wrong, it can lead to financial setbacks, medical standard compliance issues, and unnecessary stress. Poor communication between departments : Credentialing requires input from many players, including HR, compliance teams, and insurance payers.

US Department of Health and Human Services 52

US Department of Health and Human Services Licensing Compliance Malpractice 52

Verisys

MARCH 12, 2024

– The best resource for monthly healthcare regulatory compliance updates. Compliance Updates: March 2024 Overlook: Board Updates Georgia : The Georgia Medical Board has extended tele-prescribing flexibility until May 1, 2024. Full enrollment as a Medicaid provider also meets these requirements. MD BOP Regulations 10.34.34.04

Regulatory Compliance 52

Regulatory Compliance Compliance Medicaid Medicaid 52

Compliancy Group

APRIL 30, 2025

This includes Medicare, Medicaid, and others. Compliancy Groups Exclusion Monitoring Tool is an exclusion screening software that helps build that structure into your workflow. The post Why Exclusion Screening Isnt Optional appeared first on Compliancy Group. It doesnt only apply to people who submit claims.

Compliance 52

Compliance Fraud FDA Medicaid 52

MedTrainer

SEPTEMBER 20, 2023

Watch this one-demand webinar for insider tips straight from seasoned compliance surveyors. Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, and pharmacies. Accreditation.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

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.?Under Train all staff on your compliance and ethics policies and procedures upon hire and at least annually.

Nursing Homes 59

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