Verisys

MARCH 1, 2024

FACIS® for Compliance and Safety: Verisys, through its flagship product FACIS® (Fraud Abuse Control Information System) , provides a gold standard dataset for sanction and exclusion screening.

Compliance 52

Compliance Fraud Licensing Governance 52

Provider Trust

JULY 8, 2022

A holistic approach to exclusion monitoring and license verifications must include monitoring of disciplinary databases such as the National Practitioner Data Bank (NPDB). Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S. Healthcare Legislation & Regulations.

Licensing 52

Licensing Malpractice Fraud Compliance 52

MedTrainer

MARCH 14, 2024

The specialist authenticates the provider’s education, work history, licenses, and other information during provider credentialing. Courtesy: This is when a hospital occasionally allows a provider to admit and treat a patient. However, not all providers need hospital privileges.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

Verisys

DECEMBER 5, 2023

For the medical staff services team at a hospital to properly verify a healthcare practitioner’s credentials, dozens of primary sources must be contacted directly, and those primary source organizations must then verify the credentials of the practitioner in question. State licensing boards verify practitioner license type and status.

Governance 52

Governance Licensing Malpractice Medicaid 52

MedTrainer

FEBRUARY 12, 2024

In this blog, we’ll outline why reporting healthcare non-compliance is non-negotiable and how software platforms make it easier to stay in compliance with the myriad regulations that govern good healthcare. Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry.

Compliance 52

Compliance Licensing Governance Fraud 52

Verisys

NOVEMBER 14, 2023

The Importance of Thorough Credentialing The credentialing process for hospitals and health systems prioritizes in-depth research and meticulous accuracy, which means that it is not a speedy process, often taking from 90 to 120 days to complete. However, verifying a provider’s credentials is essential.

Licensing 52

Licensing Medicaid Medicaid Governance 52

AIHC

MAY 31, 2022

Health care insurance fraud is a pressing problem, causing substantial and increasing costs in medical insurance programs. To combat fraud and abuse, all levels within a medical practice, hospital or health care organization must know how to protect the organization from engaging in abusive practices and violations of civil or criminal laws.

Fraud 52

Fraud Compliance Officers Compliance Medicare 52

Healthcare IT News - Telehealth

JUNE 8, 2022

But even now, hospitals and health systems should be preparing proactively to meet the regulatory demands of a post-PHE future. State government executive orders. Outside the blanket waiver, it is also a CMS reimbursement requirement that the practitioner must be licensed in the state. We spoke recently with Allison M.

US Department of Health and Human Services 183

US Department of Health and Human Services Compliance Overpayments Overpayment 183

Verisys

JULY 27, 2023

This includes licensed and unlicensed staff members, as well as partners, investors, contingent workers, agents, and contractors you do business with. The safety of your patients depends on making sound hiring decisions and ensuring that the licenses of your staff are current.

Compliance 52

Compliance Due Diligence Licensing Fraud 52

HIPAA Journal

JULY 27, 2023

Norton Healthcare, a Kentucky-based operator of more than 140 clinics and hospitals in Kentucky and Southern Indiana, is facing a class action lawsuit over a May 2023 cyberattack and data breach.

Ransomware 52

Ransomware Fraud Licensing Health Insurance 52

Verisys

JULY 5, 2023

This includes licensed and unlicensed staff members, as well as partners, investors, contingent workers, agents, and contractors you do business with. Not only does thorough screening and rigorous continuous monitoring help ensure quality employees, but it also provides 360-degree transparency.

Compliance 52

Compliance Due Diligence Licensing Fraud 52

MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Department of Health and Human Services focuses on preventing fraud, abuse, and waste in federal healthcare programs. What is Healthcare Compliance?

Compliance 52

Compliance Fraud Medicaid Medicaid 52

MedTrainer

OCTOBER 4, 2023

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.

Compliance 52

Compliance Fraud HIPAA Governance 52

YouCompli

JULY 26, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. Situation One: Before the Pandemic   In April 2019, government officials announced Operation Brace Yourself: a fraud takedown related to telemedicine and durable medical equipment (DME).

Fraud 52

Fraud Compliance Medicare Medicare 52

Healthcare IT News - Telehealth

JANUARY 26, 2022

Ain Shams University Virtual Hospital (ASUVH) in Cairo, Egypt, employs a model of care where they reach patients throughout the continent by connecting with local clinics. Further, telehealth providers can help reduce the chance for fraud, waste and abuse by implementing risk-management policies and mechanisms.

Fraud 148

Fraud Telemedicine COVID-19 Licensing 148

MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. Compliance in healthcare began to encompass billing, fraud, and abuse prevention.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

HIT Consultant

DECEMBER 10, 2021

Fraud Schemes in a Telehealth Era: What Healthcare Payers Should Know. What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. Report Background.

COVID-19 98

COVID-19 Fraud Nurses Licensing 98

Verisys

MARCH 1, 2022

For the medical staff services team at a hospital to properly verify a healthcare practitioner’s credentials, dozens of primary sources must be contacted directly, and those primary source organizations must then verify the credentials of the practitioner in question. State licensing boards verify practitioner license type and status.

Governance 52

Governance Licensing Malpractice Medicaid 52

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. Facilities increasingly rely on healthcare compliance officers (HCOs) to bridge the gap between government regulation and daily operations.

Compliance Officers 52

Compliance Officers Compliance US Department of Health and Human Services Governance 52

Verisys

JANUARY 18, 2022

The credentialing process for hospitals and health systems prioritizes in-depth research and meticulous accuracy, which means that it is not a speedy process, often taking from 90 to 120 days to complete. Provider information should be continuously monitored for any changes to exclusion or license status.

Licensing 52

Licensing Medicaid Medicaid Governance 52

YouCompli

DECEMBER 7, 2022

These exclusions are generally related to criminal activity like fraud or healthcare-related misconduct. Felony convictions for other healthcare-related fraud, theft, or other financial misconduct. A Puerto Rican hospital settled for $105,000 for allegedly hiring an excluded individual as a medical utilization director.

Fraud 52

Fraud US Department of Health and Human Services Compliance Medicaid 52

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

HIPAA Journal

OCTOBER 10, 2022

The presentation was then forwarded by the Council to employees working for certain county government agencies and the presentation was posted to the DHS website as part of the meeting minutes. According to the substitute breach notification on the law firm’s website, the security breach was detected on August 9, 2021.

Medicaid 55

Medicaid Medicaid Governance Fraud 55

Hall Render

JULY 28, 2023

million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Healthcare Law Blog

JULY 5, 2022

As always, with technology comes data, and experts weighed in on issues like data use, licensing, aggregation, new rules on information blocking, ransomware attacks/cyber insurance, and preparing for disasters, whether natural or human-made. Regulatory and Enforcement Environment. Antitrust and Labor Relations.

Fraud 52

Fraud Governance Ransomware Licensing 52

AIHC

JUNE 6, 2023

Algorithms perform relatively well on knowledge-based tests despite the lack of domain-specific training; ChatGPT achieved ~ 66% and ~ 72% on Basic Life Support and Advanced Cardiovascular Life Support tests, respectively, and performed at or near the passing threshold on the United States Medical Licensing Exam.

Compliance 59

Compliance Medical Billing HIPAA Due Diligence 59

Hall Render

NOVEMBER 15, 2023

Split and Shared Care Visits Medicare regulations do not allow a physician to bill for services provided incident to their professional services in the hospital, because “incident to” services are paid to the hospital through the facility payment. 42 CFR 482.22 (emphasis added).

Medicare 40

Medicare Medicare Medicaid Medicaid 40

AIHC

SEPTEMBER 5, 2023

Telehealth reduces the cost of healthcare and increases efficiency with better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays. This compact does not apply to nurse practitioners (NPs) because they are licensed under state boards of nursing and not medicine.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

AIHC

JUNE 6, 2023

Algorithms perform relatively well on knowledge-based tests despite the lack of domain-specific training; ChatGPT achieved ~ 66% and ~ 72% on Basic Life Support and Advanced Cardiovascular Life Support tests, respectively, and performed at or near the passing threshold on the United States Medical Licensing Exam.

Compliance 52

Compliance Medical Billing HIPAA Due Diligence 52

Health Law Advisor

MARCH 1, 2023

On February 14, 2023, the Utah Senate passed a bill that would repeal the State’s “Online Prescribing, Dispensing, and Facilitation Licensing Act” (“Online Prescribing Act”). States and the federal government have been taking sides on the ability of pharmacies to dispense mail-order medications used for abortion. 1] [link]. [2]

Telemedicine 52

Telemedicine COVID-19 Fraud Licensing 52

Verisys

MAY 9, 2023

These regulatory programs ensure that reimbursement happens only for licensed practitioners and healthcare entities in good standing with the Office of Inspector General (OIG). Healthcare organizations must align their practices to comply with OIG regulations.

Compliance 52

Compliance Fraud Governance Licensing 52

Provider Trust

FEBRUARY 3, 2023

In a recent study by Becker’s Hospital Review , 17 different hospitals reported having to scale back for a variety of reasons, including staffing issues and financial challenges. The government and private whistleblowers have increasingly targeted PE firms’ portfolio companies and the firms themselves.

Compliance 52

Compliance Fraud Nurses Telemedicine 52

Hall Render

MARCH 3, 2023

NATIONAL 14 rural senators push CMS to extend low-wage hospitals’ payment bump in FY2024 American Hospital Association voices support for telehealth expansion bill Behavioral health market to hit $262B by 2029 Biden administration moves to establish ‘guardrails’ for telehealth prescriptions CMS Officials Confirm End of PHE Nursing (..)

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

MAY 19, 2023

Supplemental Grant for Rural Health Programs UAMS to Study Affordable Care Act’s Impact on Breast Cancer Treatment Arkansas Children’s Hospital Auxiliary Donates $1.4 Supplemental Grant for Rural Health Programs UAMS to Study Affordable Care Act’s Impact on Breast Cancer Treatment Arkansas Children’s Hospital Auxiliary Donates $1.4

Nurses 40

Nurses COVID-19 Hospitals Nursing Homes 40

Hall Render

MARCH 31, 2023

in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? What happens if it disappears?

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

Hall Render

JULY 22, 2022

cancer, cardio lab fraud. Omicron variant fueling uptick in Alabama COVID-19 hospitalizations. Five leading children’s hospitals secure $29M in federal funding to enhance future pandemic readiness. Hospital holds 2nd CEO candidate meet and greet: Dennis Welsh talks the future of Juneau’s health care community. CALIFORNIA.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

DECEMBER 22, 2023

Million in Retaliation Suit John Muir, Tenet scrap hospital deal after FTC challenge Kaiser to lay off 79 administrative employees Leaning toward big wins in schizophrenia and vaccines, venture group raises new fund of $389 million Madera hospital creditors want to be paid, including CEO. health care spending hits $4.5

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40