Healthcare Law Blog

FEBRUARY 3, 2023

New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1]

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MedTrainer

JANUARY 10, 2024

It may seem a little early to do some spring cleaning, but not when it comes to compliance! It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. Release of Industry-Specific Compliance Program Guidance (ICPG) is anticipated in 2024.

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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. This update applies to Fee-For-Service (FFS) claims and will be implemented in two phases.

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Bill of Health

APRIL 13, 2022

The COVID-19 Public Health Emergency (PHE) expires at the end of this week, with Department of Health and Human Services (HHS) Secretary Xavier Becerra expected to renew the PHE once more to extend through mid-July. The post Churntables: A Look at the Record on Medicaid Redetermination Plans appeared first on Bill of Health.

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Provider Trust

APRIL 18, 2024

This comprehensive program provides healthcare organizations across the continuum of care a roadmap to implement top-tier compliance standards by addressing key population monitoring gaps, prioritizing financial efficiencies, and upholding community healthcare and success.

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MedTrainer

JANUARY 30, 2024

What types of healthcare facilities are required by the government to have a compliance program? Like most regulations, it depends on the size and type of healthcare facility, the services it provides, and the patients it serves. What is Healthcare Compliance? Is a Compliance Program Useful If It’s Not Mandated?

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MedTrainer

APRIL 11, 2024

There is one way to describe the relationship between HR professionals and compliance officers: It’s complicated. As you see these roles work together, you might wonder about the difference between a compliance officer and human resources in healthcare. Ultimately, both roles foster a healthy, law-abiding, and efficient workplace.

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Compliancy Group

FEBRUARY 28, 2024

Many industries have compliance rules and regulations to meet and follow, but few would argue that healthcare is one of the most stringent. Privacy and security – Compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations to protect patient privacy and data security is crucial.

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Medisys Compliance

APRIL 24, 2024

HIPAA compliance helps ensure their privacy and encourages them to seek treatment without fear of their information being disclosed. Breach Notification Rule: If a security breach occurs and PHI is compromised, this rule mandates that you notify affected individuals and the Department of Health and Human Services (HHS).

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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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Verisys

JANUARY 8, 2024

OIG compliance refers to adherence to the guidelines and regulations set forth by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services. The OIG is responsible for combating fraud, waste, and abuse in health and human services programs, including Medicare and Medicaid.

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MedTrainer

FEBRUARY 12, 2024

Knowingly or falsely claiming monies from federal programs such as Medicare and Medicaid has cost healthcare entities $72B since 1986. How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims?

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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. An example is knowingly billing for services a doctor hasn’t provided.

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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 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.

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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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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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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 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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Compliancy Group

MARCH 19, 2024

Hospitals and private practices aren’t the only enterprises with compliance obligations within this sector. Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. name, phone number).

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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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Verisys

JANUARY 8, 2024

A healthcare compliance audit is a thorough review and examination of an organization’s adherence to regulatory guidelines. This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations.

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Compliancy Group

JANUARY 3, 2024

One of the most common ways for providers and healthcare organizations to run afoul is to incorrectly or illegally bill and code for services or supplies. 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.

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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.

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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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Medisys Compliance

MAY 7, 2024

This is where a dedicated mental health billing service can make a world of difference, offering substantial benefits that can help providers reduce stress and regain valuable time to focus on patient care. Here’s where a mental health billing service can be a game-changer.

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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?

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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.

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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?

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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.

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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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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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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

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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Compliancy Group

APRIL 4, 2024

These are just some of the things that OIG compliance guidelines help prevent. Operating under the Department of Health & Human Services (HHS), the OIG is essential for ensuring efficiency across multiple programs like Medicare and Medicaid.

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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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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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