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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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Who Is Responsible For Compliance In Healthcare?

MedTrainer

Healthcare Compliance Complexities The first healthcare compliance programs began in the early 20th century as a response to concerns about the quality of care provided by medical practitioners. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care.

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NYS DFS Revisits PBM Regulation with Scaled-Back Draft Rules

Health Care Law Brief

On February 6, 2024, the New York State Department of Financial Services (“DFS”) released “pre-proposed” consolidated rulemaking related to the business practices of Pharmacy Benefit Managers (“PBMs”) licensed to operate in New York.

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What is GRC in Healthcare?

Verisys

Healthcare compliance is a critical component in the operation of healthcare organizations, encompassing a broad range of activities designed to ensure adherence to applicable laws, regulations, and ethical standards. For instance, within the realm of healthcare compliance, HIPAA compliance plays a pivotal role.

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Key Legal Issues Facing Telehealth Platforms, as Compliance Concerns Bubble for Platforms Launched During the Public Health Emergency

Health Care Law Brief

For example, New York continues to maintain a professional licensing waiver that enables certain providers, licensed out of state, to render care within the state, for the duration of the declared state of emergency. Provider Licenses. What types of providers will render care via telehealth?

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Key Legal Considerations Relating to Ketamine Behavioral Health Platforms

Health Care Law Brief

Notably, ketamine infusions or prescriptions for behavioral health matters are generally not reimbursable by Medicare or other federal health care programs. Assuming compliance with related laws, a ketamine clinic could largely operate with the federal DEA licenses and state controlled substance licenses of its providers.

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New York Enacts Landmark Legislation Regulating PBMs

Health Care Law Brief

In an approval memo, Governor Hochul described the New York legislation as the most comprehensive regulatory framework in the country for PBMs. The new law requires PBMs to register with the State Department of Financial Services (DFS) by April 1, 2022 and thereafter to be licensed by January 1, 2023. Disclosure requirements.