Verisys

JULY 20, 2023

3: Allowing a physician to treat patients before credentialing is completed Courts have held hospitals liable when a physician falsifies credentials, and the hospital fails to do its due diligence in verifying them. Therefore, due diligence requires background checks to identify current and historical adverse actions.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

HIPAA Journal

MARCH 30, 2023

This was in response to the growing level of healthcare fraud and abuse and an alleged “compliance disconnect” at the executive level in many hospitals and health systems. The biggest influence for the creation of the seven elements of a compliance program (fraud prevention) is sometimes overlooked.

Compliance 97

Compliance Compliance Officers Fraud HIPAA 97

Provider Trust

MAY 17, 2022

Federal regulators such as the HHS-OIG, the Department of Justice (DOJ), the Centers for Medicare and Medicaid Services (CMS), and others have regulations and guidelines regarding the prohibition of reimbursements of federal healthcare dollars (Medicaid, Medicare, CHIPS, TriCare, and others) to excluded vendors.

Compliance 52

Compliance Medicare Medicare Due Diligence 52

HIPAA Journal

DECEMBER 31, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was introduced to simplify the administration of healthcare, eliminate wastage, prevent healthcare fraud, and ensure employees could maintain healthcare coverage between jobs. What is HIPAA and Who Does It Apply To? What is considered a HIPAA violation?

HIPAA 132

HIPAA Due Diligence Compliance Fraud 132

MedTrainer

AUGUST 2, 2023

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. But how do you know which one to choose?

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Provider Trust

MAY 18, 2022

Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. Recent cases of OIG enforcement and other fines, penalties related to vendors.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

Hall Render

JANUARY 11, 2023

For example, reimbursement under Medicare and Medicaid for certain telemedicine services was significantly increased due to the COVID-19 pandemic. State law – App developers should also be mindful of the numerous state laws that may apply to the provision of health services through their apps.

Compliance 40

Compliance HIPAA FDA Due Diligence 40