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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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OIG Issues Special Fraud Alert Regarding Telemedicine Arrangements

Health Care Law Brief

On July 20, 2022, the Office of Inspector General for the Department of Health and Human Services (“ OIG ”) issued a special fraud alert (“ Alert ”) advising “practitioners to exercise caution when entering into arrangements with purported telemedicine companies.” OIG Flags Seven Characteristics of Telehealth Fraud.

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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. Generally, compliance officers ensure that OIG internal monitoring and auditing.

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2023 CMS Audit Protocols: What You Need to Know

Innovaare Compliance

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. The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans.

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What Is Provider Credentialing?

MedTrainer

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. Primary source verification is done by contacting educational institutions, licensing boards, and other relevant authorities.