Verisys

NOVEMBER 30, 2022

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. 38 Medicaid Sanctions.

Regulatory Compliance 52

Regulatory Compliance Medicare Medicare Medicaid 52

MedTrainer

FEBRUARY 1, 2024

Why Healthcare Corporate Compliance is Critical Healthcare facilities use corporate compliance programs for several important reasons: Reduce Risk-related Costs: Potential costs can arise from a variety of compliance risks including operational, legal, clinical, and financial.

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 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

HIT Consultant

AUGUST 3, 2022

Medicaid reimbursement, which comprises the largest share of nursing home reimbursement, has not kept pace, resulting in SNFs and medical providers assuming the burden of those costs. . A Regulatory compliance and survey process both distract and often assault a beaten-up staff and push people out of service to the facilities.

Nursing Homes 98

Nursing Homes Nurses COVID-19 Medicaid 98

Medisys Compliance

JUNE 14, 2023

Regulatory Compliance Another significant challenge in medical billing is ensuring compliance with the complex web of healthcare regulations. To conclude, medical billing in Alabama presents a range of challenges that healthcare providers must overcome to ensure efficient revenue cycle management.

Medical Billing 52

Medical Billing Medical Billing Services Regulatory Compliance Medical Billing Outsourcing 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

MARCH 28, 2024

Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations. Advises on compliance matters, reviews contracts, and handles regulatory and legal issues. Pros: Legal and regulatory compliance expertise, familiarity with laws and regulations, and trusted legal adviser.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

Verisys

DECEMBER 22, 2021

Should a group health plan, insurer, or state agency find that time is running out on achieving regulatory compliance with H.R. As a product manager at the healthcare technology and services company Verisys , he guides many of the solutions that support health plans, health systems, and state Medicare and Medicaid agencies.

Compliance 52

Compliance Regulatory Compliance Healthcare information Technology Health Insurance 52

Medisys Compliance

APRIL 25, 2023

Need of Choosing Oncology Billing Company As an oncology practice, selecting the right billing company is a crucial decision that can significantly impact your financial success and regulatory compliance. This article will discuss key factors in choosing oncology billing company.

Regulatory Compliance 52

Regulatory Compliance Compliance ACA Medical Billing Outsourcing 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 Regulatory Compliance 52

Verisys

OCTOBER 23, 2023

Medicaid providers are no longer required to use the centralized credentials verification organization to complete enrollment requirements. These changes will be effective 01/01/2024. This is a summary of the changes to Indiana’s healthcare provider credentialing requirements.This is not a comprehensive list of all changes.

Licensing 52

Licensing Nurses Compliance Medicaid 52

Health Care Law Brief

JUNE 2, 2022

Therefore, a telehealth platform operating in all 50 states will, for example, need to comport with the laws governing corporate formation, provider licensure, scope of practice, and telehealth encounters in all 50 states. Does the state apply different standards, for example, to Medicaid encounters? How is this disclosed to consumers?

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Healthcare Law Today

JANUARY 20, 2022

The entity is also prohibited from billing Medicare or, possibly, Medicaid for such referrals. These arrangements must be carefully structured, however, and should be reviewed by compliance counsel. Foley is here to help you address the short- and long-term impacts in the wake of regulatory changes.

Compliance 52

Compliance Medicare Medicare COVID-19 52

Health Care Law Brief

NOVEMBER 9, 2021

Additionally, and as we touched upon in our January 7, 2021 post on the No Surprises Act , these new measures supplement state laws governing surprise medical billing, and so in cases where a state No Surprises law applies, the state law generally determines an individual’s OON payment rate. [1]. 2] See 86 Fed.

Medical Billing 75

Medical Billing Due Diligence Compliance Patient Satisfaction 75

MedTrainer

AUGUST 30, 2023

Medicaid Managed Care. Some state Medicaid programs contract with managed care organizations to provide healthcare services to eligible beneficiaries. These plans follow managed care principles to control costs and improve care coordination for Medicaid recipients.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

HIT Consultant

APRIL 16, 2024

Eric Demers, CEO Madaket Health In 2022, the Centers for Medicare & Medicaid Services (CMS) proposed the creation of a centralized physician directory. Of course, these solutions must address key challenges such as data fluctuations, standardization issues, and regulatory compliance.

Regulatory Compliance 52

Regulatory Compliance Compliance Health Insurance Medicaid 52

MedTrainer

OCTOBER 5, 2023

As a key member of your facility’s healthcare compliance programming, you understand the significance of regulatory compliance and the critical role it plays in ensuring the privacy and security of patient information. Use this guide for creating the reports you need to satisfy OCR and other governing body inspections.

HIPAA 98

HIPAA Compliance Regulatory Compliance ADA 98

MedTrainer

AUGUST 2, 2023

Legal and Regulatory Compliance Healthcare facilities and insurance companies are legally obligated to credential providers before allowing them to practice or join their networks. By verifying education, training, and experience, organizations help prevent unqualified or incompetent individuals from delivering care to patients.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Florida Health Care Law Firm

DECEMBER 2, 2021

As described on the OIG website, “Self-disclosures give persons the opportunity to avoid the costs and disruptions associated with a Government-directed investigation and civil or administrative litigation.”. Each case will be determined individually.

Overpayments 40

Overpayments Overpayment Fraud Medicare 40

HIT Consultant

OCTOBER 4, 2021

The Centers for Medicare and Medicaid Services (CMS) strive for innovations in healthcare technologies that drive down costs and improve the patient experience. But they also significantly increase the risk of data breaches, requiring all healthcare organizations to layer an effective security and governance protection over those new APIs.

Regulatory Compliance 52

Regulatory Compliance Governance Medicaid Medicaid 52

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

JANUARY 25, 2024

But the UHC entities included Medicare Advantage Organizations (“MAOs,” not to be confused with monoamine oxidase inhibitors or any particular potentate) regulated by the Centers for Medicare and Medicaid Services (“CMS”) applying various Medicare laws and regulations.

Medicare 52

Medicare Medicare FDA Regulatory Compliance 52