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Handling an OIG Audit with Confidence: Focus Areas for 2024

Compliancy Group

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. Medicare Advantage (M.A.): and cybersecurity threats. Organizations using M.A.

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What is GRC in Healthcare?

Verisys

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is healthcare data governance?

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Why Do Healthcare Facilities Use Corporate Compliance Programs?

MedTrainer

A corporate compliance program in healthcare is a comprehensive set of policies, procedures, and practices that healthcare organizations establish and maintain to ensure that they operate compliant with all applicable laws, regulations, and ethical standards. Why do healthcare facilities use corporate compliance programs?

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What is FACIS and Why is it the Gold Standard

Verisys

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. organizations that receive any funds from Medicare, Medicaid, TRICARE, or other federal programs cannot afford to employ individuals or entities excluded from even one program. Medicare opt out.

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What is a Healthcare Compliance Audit?

Verisys

This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations. Compliance with state-specific healthcare laws and regulations is also assessed.

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2023 CMS Audit Protocols: What You Need to Know

Innovaare Compliance

The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. These changes, which went into effect on January 1, 2023, are designed to ensure health plans are accurately reporting their costs and that they are not overcharging the government.

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What Are The Current Regulatory Changes And Compliance Requirements That ASCs Need To Be Aware Of In Their Billing Practices?

Healthcare IT Today

However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. Medicare Certification ASCs must sign a contract with Medicare and meet its Conditions for Coverage (CFC) to be paid. ASCs must also meet Medicare’s Conditions for Coverage.