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Which Compliance Framework Governs the Healthcare Industry?

MedTrainer

Department of Health and Human Services The United States Department of Health and Human Services (HHS) is the primary federal agency responsible for protecting the health of all Americans and providing essential human services. Schedule a demo today. The post Which Compliance Framework Governs the Healthcare Industry?

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Physician Coding and Billing Enforcement: What to Watch For

YouCompli

In March of 2022, a New Jersey rheumatologist was convicted by a federal jury for defrauding Medicare and other health insurance programs. The doctor will be sentenced in July for multiple counts of healthcare fraud. He faces up to 20 years in prison for healthcare fraud and wire fraud conspiracy.

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Federal and State Healthcare Compliance Requirements

MedTrainer

These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. These requirements are designed to protect patient rights, privacy, and safety, as well as to prevent fraud, abuse, and other improper practices within healthcare organizations.

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What Is Medical Auditing?

MedTrainer

They review healthcare claims and billing practices to ensure accuracy, detect fraud or abuse, and assess compliance with the payer’s policies and guidelines. Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS). The post What Is Medical Auditing?

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Health Provider News – June 3, 2022

Hall Render

4 benefits of behavioral health partnership for hospital performance. AHA presses for False Claims Act probes to target payers over Medicare Advantage denials. Court OKs denying coverage for mental health, substance-use care. Senator asks HHS to keep Laguna Honda Hospital open after losing Medicare funding. NEW JERSEY.