Compliance Now

AUGUST 10, 2023

This request is not mandatory for employers, and there are significant compliance considerations for employers that extend the enrollment window for this population. During the recent public health emergency declared as a result of the COVID-19 pandemic, state agencies did not terminate individuals’ Medicaid or CHIP coverage.

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Medicaid Medicaid COVID-19 Compliance 100

Medisys Compliance

JANUARY 23, 2025

Telehealth has revolutionized mental health care by making it more accessible to patients regardless of their geographic location. As we step into 2025, mental health providers must stay informed about evolving telehealth billing regulations to ensure compliance and optimize reimbursement. 90846 and 90847: Family psychotherapy.

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Medical Billing Outsourcing Medicare Medicare Medical Billing 59

Compliance Now

MARCH 15, 2022

The legislation also allows both Medicare and Medicaid to continue covering select telehealth services for 151 days after the COVID-19 public health emergency ends. In addition to the extension of telemedicine protections for HDHPs, the 2022 CAA expands the scope of telehealth services that Medicare will cover.

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COVID-19 Telemedicine Medicare Medicare 189

Medisys Compliance

JANUARY 16, 2025

Behavioral health providers play a critical role in addressing mental health challenges, but navigating the complexities of billing can be daunting. The Centers for Medicare & Medicaid Services (CMS) provides comprehensive behavioral health billing guidelines, which can be overwhelming due to their technical nature and breadth.

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Medicare Medicare Medical Billing Outsourcing Fraud 59

Healthcare IT News - Telehealth

JULY 18, 2022

Karen Rheuban, cofounder and director of the Center for Telehealth and medical director of telemedicine at the University of Virginia Health System. "In addition, we built other innovative applications of virtual services to improve patient compliance, such as a virtual cardiac rehabilitation program," she continued.

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COVID-19 Telemedicine Electronic Medical Records Hospitals 197

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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Compliance Medicaid Medicaid Licensing 52

MedTrainer

SEPTEMBER 20, 2023

Watch this one-demand webinar for insider tips straight from seasoned compliance surveyors. Additionally, CMS’s guidelines, or Conditions of Participation/Conditions for Coverage (CoPs/CfCs) , are specific to each type of covered health care facility, along with regulations pertaining to each organization’s state and locality.

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Medicaid Medicaid Medicare Medicare 97

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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Compliance Licensing Public Health Compliance Officers 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.

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Compliance Licensing Medicaid 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

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 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.

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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.

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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

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

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.

Compliance 52

Compliance Licensing Public Health Medicaid 52

Health Care Law Brief

JUNE 2, 2022

The onset of the COVID-19 public health emergency (“PHE”) led to a surge in the use of telehealth by health care providers. For the reasons discussed below, DTC telehealth platforms should re-visit their compliance plans and be prepared for increased state and federal regulatory scrutiny.

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Public Health Compliance COVID-19 Licensing 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.

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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.

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Compliance Licensing Medicaid Medicaid 52

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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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. These agencies safeguard public health and ensure the competence and ethical conduct of providers.

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Compliance Licensing Regulatory Compliance Medicaid 52

MedTrainer

DECEMBER 7, 2023

The New Hampshire Department of Health and Human Services (DHHS) , along with other state agencies, is responsible for enforcing these important rules. Ensuring healthcare compliance in New Hampshire involves maintaining both federal and state guidelines, while providing quality patient care.

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Compliance Licensing Public Health Medicaid 52

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 trend in remote access to care has expanded widely and is expected to continue.

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MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital.

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Fraud Compliance Medicaid Medicaid 98

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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Compliance Compliance Officers Licensing Medicaid 52

Healthcare Law Blog

SEPTEMBER 6, 2022

In response to the COVID-19 Public Health Emergency (the “PHE”), the Centers for Medicare and Medicaid Services (“CMS”) issued numerous “blanket waivers” to increase access to medical services, and ease the regulatory burden on providers across the health care industry.

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COVID-19 Public Health Medicare Medicare 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 Department of Human Services (DHS) is the state’s Medicaid agency.

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Compliance Licensing Medicaid 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

Verisys

APRIL 3, 2025

As a centralized hub of critical practitioner data, the NPDB serves as a powerful ally in provider credentialing , helping hospitals, medical boards, and institutions verify backgrounds, track malpractice claims, and ensure regulatory compliance. Medicare and Medicaid Compliance Requirements , which mandate reporting of program exclusions.

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Malpractice Licensing Compliance Hospitals 52

MedTrainer

DECEMBER 7, 2023

State-specific governing bodies, such as the West Virginia Department of Health and Human Resources (DHHR) and the Bureau for Medical Services (BMS) , oversee and enforce these regulations. Effective management of healthcare compliance in West Virginia requires consistent adherence to both federal and state agency standards.

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Compliance Licensing Medicaid 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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Compliance Licensing Medicaid Medicaid 52

HIT Consultant

JULY 20, 2022

For most patients, it has always been extremely difficult to their personal health and medical data electronically. However, with the CMS Interoperability and Patient Access Final Rule , consumers, specifically Medicaid members, there is a greater push to give access to, and ownership of, this data. About Kristin Ballantine.

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Governance Medicaid Medicaid Public Health 97

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

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

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 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.

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Compliance Licensing Compliance Officers Informed Consent 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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Compliance Licensing Governance Public Health 52