Compliancy Group

JANUARY 17, 2024

The OIG Work Plan, sometimes referred to as “the Work Plan” or “the Plan,” is an essential tool in securing and maintaining healthcare regulatory compliance for patient safety, privacy, and quality care. OIG in healthcare , functioning as an arm of the U.S.

US Department of Health and Human Services 52

US Department of Health and Human Services Compliance Regulatory Compliance Regulations Compliance 52

Innovaare Compliance

JUNE 8, 2023

The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. These changes are significant and will have a major impact on Medicare and Medicaid plans. Plans will be required to provide more information about their quality improvement activities.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Verisys

FEBRUARY 14, 2024

Mitigating Provider Risk: Verisys’ solutions, such as FACIS® (Fraud Abuse Control Information System) , provide in-depth screening and continuous monitoring of healthcare professionals against the largest dataset of disciplinary actions and exclusions. How does Verisys help with healthcare compliance?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Healthcare IT Today

JUNE 29, 2023

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.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

MedTrainer

NOVEMBER 2, 2023

Most compliance officers possess a bachelor’s degree, often in healthcare administration, law, or a related field. Additionally, hands-on experience in healthcare or regulatory compliance provides a foundation for this role.

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

Florida Health Care Law Firm

FEBRUARY 22, 2022

In yet another take-down of an illicit scheme to defraud the Medicare Program and ChampVA, as well as other insurers, Patsy Truglia has been sentenced to 15 years in federal prison. He has also had assets forfeited since these assets were acquired with money from his ill-gotten fraud scheme. million being paid to Truglia and company.

Medicare 52

Medicare Medicare Telemedicine Fraud 52

Health Care Law Brief

APRIL 11, 2022

Notwithstanding these streams of remuneration taking the form of cash equivalents and not being protected by an AKS regulatory safe harbor or by an exception to the Beneficiary Inducements CMP, the OIG still concluded that the Arrangement presented a minimal risk of fraud and abuse based on a totality of the underlying facts and circumstances.

Fraud 52

Fraud Medicare Medicare Compliance 52

Health Care Law Brief

JUNE 2, 2022

Similarly, with respect to Medicare, Congress extended certain Medicare telehealth flexibilities for 151 days following the conclusion of the PHE, as part of the Fiscal Year 2022 Omnibus appropriations bill. If so, how will patient fees be structured to comport with these restrictions? Provider Licenses.

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Health Care Law Brief

NOVEMBER 30, 2021

However, the OIG noted that bona fide employment in which a professional reassigns billing rights in exchange for compensation is “a commonplace practice in the health care industry, explicitly authorized by … the Medicare program.”

Medicare 40

Medicare Medicare Regulatory Compliance Fraud 40

MedTrainer

AUGUST 30, 2023

Medicare Advantage (Part C). Medicare Advantage plans are managed care plans offered by private insurance companies as an alternative to traditional Medicare (Parts A and B). Some key compliance elements for managed care organizations include: Legal and Regulatory Compliance. Quality of Care Standards.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

MedTrainer

NOVEMBER 15, 2023

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.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

Florida Health Care Law Firm

DECEMBER 2, 2021

On November 8, 2021, The Department of Health & Human Services (HHS), Office of Inspector General (OIG) released a revised and renamed Provider Self-Disclosure Protocol (SDP), now known as the “Health Care Fraud Self Disclosure “protocol. The OIG recognized that there are benefits to disclose potential fraud.

Overpayments 40

Overpayments Overpayment Fraud Medicare 40

MedTrainer

AUGUST 2, 2023

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.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

HIT Consultant

DECEMBER 6, 2022

trillion Consolidated Appropriations Act of 2022, which extended Medicare coverage related to telemedicine practices. As within many areas of health care, however, expansion and innovation contributed to a higher risk of fraud and resulted in an increase in enforcement activity.

Compliance 98

Compliance Medicaid Medicaid COVID-19 98

Health Care Law Brief

MARCH 8, 2022

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, which will begin January 1, 2023, and replace the Global and Professional Direct Contracting (GPDC) Model.

Medicare 52

Medicare Medicare Fraud Compliance 52

Drug & Device Law

DECEMBER 29, 2023

2023) (rejecting any express anti-preemption presumption in Medicare case) ( here ); Baker v. 2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. Negligence requires an evaluation of a defendant’s reasonableness, and all relevant NC authority includes relevant regulatory compliance in that mix.

FDA 105

FDA US Department of Health and Human Services COVID-19 Informed Consent 105