MedTrainer

MAY 10, 2024

Credentialing confirms the providers’ eligibility to bill for services under government and accreditation regulations. Here’s what a typical credentialer’s workflow looks like: Like other providers, mental health professionals must be licensed in states where they offer services and enrolled with payers doing business in those areas.

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Licensing ACA Medicare Medicare 52

MedTrainer

FEBRUARY 5, 2024

Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. Several weeks.

Licensing 52

Licensing Governance Compliance Fraud 52

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S.

Ransomware 59

Ransomware Governance Compliance HIPAA 59

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. Additionally, there are varying, disparate State Medicaid exclusions sources that require periodic screening.

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Medicaid Medicaid Medicare Medicare 52

Healthcare IT News - Telehealth

JANUARY 23, 2023

We spoke with the HIMSS government relations team for their thoughts on those priorities and more in 2023 and beyond. HIMSS will "use the next two years to gather additional data to inform both Congress and CBO on either the cost of avoidance or the cost control aspects," said Leary.

Medicare 147

Medicare Medicare Governance Medicaid 147

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S.

Ransomware 52

Ransomware Governance Compliance HIPAA 52

MedTrainer

NOVEMBER 27, 2023

Ohio Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Ohio Department of Health (ODH) is key to safeguarding and enhancing the health of Ohio residents. The State Medical Board of Ohio provides licensing and regulatory guidelines for medical providers in Ohio State.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MAY 6, 2024

We’ll walk you through the steps to enroll providers with Aetna (a CVS Health company), the information and documents you’ll need, and best practices to follow. Aetna systems will reflect your provider’s participation effective date, and Aetna members can see the provider’s information in the directory.

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Licensing Malpractice Health Insurance Medicaid 52

Verisys

DECEMBER 5, 2023

Because they have first-hand knowledge, these primary sources can confirm if the information claimed is accurate. State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs.

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Governance Licensing Malpractice Medicaid 52

Verisys

OCTOBER 23, 2023

Alabama : License renewals for pharmacy technicians, pharmacy interns, and facilities are open as of 9/15/2023. The board urges that nurses who were practicing under an EMSA license should apply for licensure by endorsement to continue to practice in California. Here is our monthly regulatory update.

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Licensing Nurses Compliance Medicaid 52

MedTrainer

DECEMBER 4, 2023

Kentucky Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Kentucky Department for Public Health (DPH) plays a vital role in promoting and protecting the health and wellness of the citizens of Kentucky through various programs, initiatives, and health services.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

Established in 1918, NCHA plays a pivotal role in enhancing healthcare by offering information, support, educational resources, policy guidance, and advocacy to its members. The Division of Health Benefits administers the state’s Medicaid program, which provides essential healthcare coverage to eligible individuals and families.

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

MedTrainer

NOVEMBER 27, 2023

Georgia Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Georgia Department of Public Health (DPH) plays a crucial role in safeguarding the health and well-being of Georgians. Keep reading for resources, tips, and regulations unique to healthcare compliance in Georgia.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 29, 2023

Each organization needs a system in place for keeping their standards up to date and efficiently relaying the information to staff. Read on for vital information about maintaining healthcare compliance in South Carolina. The state has been proactive in expanding telehealth services , especially in rural and underserved areas.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

State-specific governing bodies, such as the Bureau of Facility Standards , provide oversight with certain standards, adding a layer of complexity to successfully managing healthcare compliance in Idaho. The Act equates virtual care’s standard to in-person care, emphasizing sufficient provider-patient relationships and informed consent.

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Compliance Licensing Compliance Officers Informed Consent 52

MedTrainer

NOVEMBER 30, 2023

Like other regions in the United States, Wisconsin is characterized by its unique blend of rules and mandates that govern healthcare compliance within the state. Medicaid Telehealth Services For healthcare providers and compliance professionals in Wisconsin, the Medicaid Telehealth Expansion is an important policy to consider.

Compliance 52

Compliance Medicaid Medicaid Licensing 52

MedTrainer

DECEMBER 7, 2023

All healthcare sites in New Mexico should develop robust compliance systems to monitor regulatory changes and keep staff informed. The New Mexico Medical Board is responsible for licensing and regulating medical practitioners in the state, ensuring that they meet professional standards for safe and ethical medical practice.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Verisys

FEBRUARY 14, 2024

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? What is GRC in Healthcare?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Health Care Law Brief

FEBRUARY 8, 2024

billion to fund Medicaid, $4.8 In addition to those provisions that look to extend current government programs, the HMH Bill proposes the following new initiatives: Provider Specific Provisions : Transforming Safety Net Hospitals. The Department of Health (“DOH”) would establish Medicaid reimbursement rates for such off-site services.

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

MedTrainer

NOVEMBER 29, 2023

Louisiana Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Louisiana Department of Health (LDH) is the state agency responsible for public health initiatives, healthcare policy, and overseeing medical services and facilities throughout Louisiana.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

HIPAA Journal

MARCH 6, 2023

Cedar Park, TX-based Dental Health Management Solutions (DHMS), a provider of dental services to the government/military and private patients has recently announced – via its legal counsel – that the protected health information of certain patients was exposed in a 2021 hacking incident.

Electronic Medical Records 74

Electronic Medical Records HIPAA Licensing Nurses 74

Verisys

NOVEMBER 14, 2023

Primary source verification must be done to confirm a provider’s education, professional license and certifications, medical training, work history, references, and more. Inaccurate or missing information can cause delays which lengthen the process even further, directly impacting billing and reimbursement.

Licensing 52

Licensing Medicaid Medicaid Governance 52

MedTrainer

NOVEMBER 28, 2023

The Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Medicaid agency, providing health care programs to serve Arizona residents through managed care, cost containment, and services aimed at improving the health of those it covers.

Compliance 52

Compliance Licensing Public Health Medicaid 52

MedTrainer

NOVEMBER 14, 2023

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Exclusion from Government Programs: Entities found non-compliant may be barred from participating in government healthcare programs like Medicare and Medicaid. What Is Healthcare Compliance?

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Compliance HIPAA Governance Medicare 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). The National Practitioner Data Bank (NPDB) is a confidential information clearinghouse operated by the U.S. For more information, view the webinar on demand.

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Licensing Malpractice Fraud Compliance 52

Pharmacy Law Blog

MAY 14, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

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Licensing Nurses Medicaid Medicaid 40

Pharmacy Law Blog

MAY 7, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

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Licensing Nurses Medicaid Medicaid 40

MedTrainer

FEBRUARY 20, 2024

Insurance credentialing is the process where a healthcare organization registers a healthcare professional through specific insurance networks or government payers , like Medicare or Medicaid, to receive reimbursement for services rendered during a patient’s visit. What is Insurance Credentialing?

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Licensing Medical Billing Compliance Medicaid 52

MedTrainer

DECEMBER 7, 2023

For example, the Office of Health Care Assurance (OHCA) is one governing body that healthcare professionals need to understand in order to manage organizational licensure and healthcare compliance in Hawaii effectively. As with any inter-state provider pact, physicians are required to meet the licensing requirements of the pact.

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Compliance Compliance Officers Licensing Medicaid 52

MedTrainer

DECEMBER 7, 2023

MaineCare , operating under the Maine Department of Health and Human Services (DHHS), is the state’s Medicaid program, providing essential health coverage to eligible low-income residents, thereby enhancing access to quality healthcare services in Maine.

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Compliance Licensing Compliance Officers Medicaid 52

HIT Consultant

DECEMBER 14, 2021

They are focused on expanding the number of providers who can prescribe the treatment (it requires a special waiver from the federal government) and training more clinicians to provide support needed for the treatment to be successful. government agencies to develop OUD treatment protocols for decades.

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Licensing Governance FDA Telemedicine 98

MedTrainer

NOVEMBER 17, 2023

Managing healthcare compliance in Illinois requires healthcare organizations and professionals to stay informed about state-specific regulations while also adhering to federal healthcare compliance standards. Medical licensing is provided by the Illinois Department of Financial and Professional Regulation.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 30, 2023

Minnesota, distinct from other states, carries a unique landscape of regulations and standards that govern its healthcare compliance. The Minnesota Board of Medical Practice is a regulatory body responsible for licensing medical professionals and ensuring the ethical and competent practice of medicine within the state of Minnesota.

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Compliance Licensing Public Health Governance 52

MedTrainer

DECEMBER 4, 2023

The Division of Medicaid and Long-Term Care within DHHS is responsible for administering Medicaid services and overseeing long-term care programs, ensuring accessible and quality healthcare for vulnerable populations in Nebraska. This centralized repository ensures all employees have easy access to essential information.

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Compliance Licensing Nursing Homes Nurses 52

MedTrainer

NOVEMBER 20, 2023

Florida Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Florida Department of Health (DOH) plays a crucial role in promoting and safeguarding the wellbeing of Floridians. While many states have rules that prohibit the storage of Medicaid data outside the U.S.,

Compliance 52

Compliance Licensing Regulatory Compliance Medicaid 52

MedTrainer

OCTOBER 4, 2023

Federal healthcare compliance requirements encompass a set of regulations and laws established by various government agencies to ensure certain standards for the healthcare industry at the national level. CMS plays a crucial role in overseeing federal healthcare programs, including Medicare and Medicaid. Office for Civil Rights (OCR).

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Compliance Fraud HIPAA Governance 52

MedTrainer

NOVEMBER 20, 2023

Texas Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Texas Department of State Health Services (DSHS) plays a crucial role in promoting the health and wellbeing of Texans. The Texas HHS oversees regulations for Medicare- and state Medicaid-funded services.

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Compliance Licensing Public Health Governance 52