Healthcare IT News - Telehealth

JUNE 8, 2022

The Department of Health and Human Services once again (for the ninth time) extended the public health emergency this past month , stretching it beyond mid-July. But sooner or later, that provision of the Public Health Service Act will draw to a close. We spoke recently with Allison M.

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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.

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Healthcare IT Today

JANUARY 2, 2024

Combining this with the increasing number of digital-first health applications and services on the market, protecting data at every touchpoint is mission-critical. By analyzing policyholder data trends, health insurers can learn where their resources are over or underutilized and adjust as needed to better balance their initiatives.

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Provider Trust

MARCH 21, 2023

US Department of Health and Human Services (HHS) Office of Inspector General Christi A. Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs.

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Medisys Compliance

JULY 25, 2022

Recently published watchdog report found that private Medicare plans routinely rejected claims that should have been paid and denied services that reviewers found to be medically necessary. For detailed understanding we shared observations of OIG where they found that some of the claims were wrongly denied by private Medicare plans.

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YouCompli

SEPTEMBER 6, 2023

But very quickly, as a compliance officer, I realized that I was managing multiple projects every day. I was responsible for allocating financial, human, and physical resources to accomplish certain tasks.   Conducting annual compliance training is a project.   Was “project manager” in your current or previous job descriptions?

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YouCompli

NOVEMBER 30, 2022

How to use the SBAR Framework. The same tool nurses use to communicate about health emergencies – can help you secure investment in your compliance department. . Over the past few years, I’ve helped many of our clients demonstrate the value of investing in compliance with an?SBAR. Explain your assessment.

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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.

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YouCompli

FEBRUARY 22, 2023

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. The CCR is determined by a hospital’s cost report that is reconciled with the local Medicare contractor.

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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.

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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.

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MedTrainer

FEBRUARY 29, 2024

The World Health Organization (WHO) defines a near miss as “an error that has the potential to cause an adverse event [patient harm] but fails to do so because of chance or because it is intercepted.” More than three-fourths (77%) were due to emergency department overcrowding and medication administration errors.

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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.

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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.

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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. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.

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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.

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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.

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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 to resolve allegations that it violated the False Claims Act by submitting false claims to the Medicare program. The complaint alleged that the provider had engaged in conduct to defraud the Medicare program. to the United States.

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Healthcare Compliance Blog

MAY 19, 2022

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. Following an internal review and audit, the hospital discovered irregularities regarding its billing of certain services, and proactively contacted the United States to self-disclose the issues.?The to resolve the claims.

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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.

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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.

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Healthcare IT Today

AUGUST 28, 2023

Stephen Sofoul, SVP, Data & Decision Science Services at MultiPlan A critical challenge lies in the shortage of experienced financial analysts or data analysts capable of effectively analyzing the wealth of information that the healthcare industry holds. However, with healthcare being ever-evolving our regulations are also ever evolving.

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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. Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare.

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Healthcare IT News - Telehealth

NOVEMBER 25, 2020

Department of Health and Human Services' final rules regarding the Physician Self-Referral Law (also known as the Stark Law) and the Federal Anti-Kickback Statute. The American Telemedicine Association this week issued a statement in response to the U.S. WHY IT MATTERS.

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YouCompli

DECEMBER 7, 2022

Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.

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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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Med-Net Compliance

SEPTEMBER 20, 2022

million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. According to court documents and evidence presented at trial, the podiatrist was revoked from participating in the Medicare program in January 2015.

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Med-Net Compliance

JUNE 22, 2022

Investigation of the case was conducted by the US Department of Veterans Affairs-Office of Inspector General (VA-OIG), VA Police Detroit and the Medicare Fraud Strike Force (MFSF) partners, a partnership among the Criminal Division, US Attorney’s Offices, and US Health and Human Services-Office of Inspector General (HHS-OIG).

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Innovaare Compliance

JUNE 21, 2023

The Inflation Reduction Act of 2022 has wide-ranging impact on payments for drugs used by Medicare beneficiaries, whether they are administered in the provider’s office (Part B) or used in the ambulatory setting (Part D). Part B drugs have had the fastest spending growth for drugs for Medicare. percent annually.

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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).

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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).

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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).

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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.

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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”. Here is our monthly regulatory update. Also the removal of obsolete and irrelevant information. (§302)

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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.

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Healthcare Compliance Blog

MAY 10, 2022

The provider had created a business to provide home and community-based services to Medicaid recipients. The provider had created a business to provide home and community-based services to Medicaid recipients. An ineligible Medicaid provider was arrested in Florida for defrauding Medicaid of more than $68,000.

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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.

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