Compliancy Group
MARCH 22, 2024
Compliance Program A comprehensive way to avoid Medicare exclusion is to develop an organization-wide compliance program, one of the Centers for Medicare and Medicaid Services (CMS) requirements. For example, a risk assessment can shed light on conditions that make fraud, waste, and abuse most likely to occur.
HIPAA Journal
DECEMBER 30, 2022
Also, the breach notification letters stated, in bold and underlined text, that electronic medical records had not been accessed when the next paragraph made it clear that the information contained in medical records had in fact been accessed.
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Compliancy Group
MARCH 19, 2024
Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number).
Provider Trust
JULY 25, 2022
To eliminate fraud in your health ecosystem, you must stay compliant with federal and state requirements for referring and ordering physicians. While your electronic medical record (EMR) will have some data relating to practitioners, these systems can become out-of-date quickly if not regularly maintained and updated.
AIHC
APRIL 5, 2022
Due to the huge volume of claims payers receive to process, deny and pay, they have implemented various methods to track providers to detect potential waste, fraud and/or abuse. It can result in a situation where insurance opens an investigation or decides to initiate periodic audits on your claims and records. They can, sometimes!
Health Care Law Brief
APRIL 12, 2023
On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. 405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. Parts 417, 422, 423, 455, and 460.
Healthcare Law Blog
FEBRUARY 1, 2023
If finalized, the Centers for Medicare and Medicaid Services (CMS) Proposed Rule on Advancing Interoperability and Improving Prior Authorization Processes will require payers to participate in electronic payer-to-payer data exchange and implement automated prior authorization processes.
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