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Fraud-Proofing Your Telehealth Strategy

HIT Consultant

The numbers lend credence to the numerous benefits touted throughout the public health emergency, most notably serving as a vital lifeline for high-risk patients, reducing the risk of exposure for staff, alleviating patient demand on facilities, and more. Identification to Inform Action.

Fraud 98
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Which Compliance Framework Governs the Healthcare Industry?

MedTrainer

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

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2024 HHS-OIG Top Areas of Focus

Provider Trust

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

Fraud 52
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DOJ Announces $2.68 Billion in False Claims Act Recoveries

Hall Render

Whistleblowers continue to be one of the federal government’s greatest assets in FCA cases, with qui tam actions accounting for over $2.3 billion is attributed to cases involving the health care industry, including managed care providers, hospitals, pharmacies, laboratories, long-term acute care facilities and physicians.

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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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Editorial: Time to Stop Blocking a National Patient Identifier System

HIPAA Journal

health system, not for any form of control, government interference in healthcare, or any other nefarious purpose, but to address a pressing public health and safety issue: To ensure patients can be reliably and accurately connected with their health information. This is far from an isolated example.

HIPAA 102
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DOJ Recouped $5.6 Billion Under FCA in 2021

Hall Render

Of that, $5 billion relates to health care fraud involving drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians. Health Care Fraud Actions. That figure does not include even more funds recovered for state Medicaid programs.

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