Verisys

JANUARY 8, 2024

This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations. Compliance with state-specific healthcare laws and regulations is also assessed.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

Total Medical ComplianceHIPAA

JANUARY 11, 2024

These screenings search through various databases containing records of individuals or organizations barred from participating in Medicaid, Medicare, or other federal/state healthcare programs due to fraud, abuse, or other offenses. Why is Sanction Screening Vital Under HIPAA?

HIPAA 52

HIPAA Regulatory Compliance Malpractice Compliance 52

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.

US Department of Health and Human Services 52

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

Compliancy Group

APRIL 17, 2024

are subject to OIG risk adjustment audits, which can result in payment adjustments based on beneficiary health status and risk adjustment data that entities submit to the Centers for Medicare and Medicaid Services. Quality of Care : For the first time, the GCPG recommends that compliance programs implement patient care and safety evaluations.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Medisys Compliance

MARCH 7, 2024

Our team of experienced professionals utilizes cutting-edge technology and industry expertise to streamline processes, maximize reimbursements, and ensure regulatory compliance. MDS offers comprehensive billing solutions tailored to meet the unique needs of each client.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Regulatory Compliance Compliance 59

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

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. Increased use of data analytics: CMS will be using data analytics more extensively in its audits.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Medisys Compliance

MARCH 27, 2024

Expertise in Regulatory Compliance: The regulatory landscape for healthcare billing is constantly evolving. A specialized billing partner stays updated on the latest regulations and ensures your practice adheres to all coding and billing compliance standards.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Regulatory Compliance Compliance 64

Innovaare Compliance

JULY 20, 2023

Leveraging technology empowers health plans to strengthen their oversight capabilities, ensure regulatory compliance, and uphold high-quality care delivery through delegated entities.

Regulatory Compliance 40

Regulatory Compliance Compliance Medicaid Medicaid 40

Verisys

FEBRUARY 14, 2024

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.

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 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

Innovaare Compliance

APRIL 29, 2022

The Centers for Medicare & Medicaid Services (CMS) launched a new cycle of program audits in February 2022. Multiple Medicare Advantage Prescription Drug Plans (MAPDs) have already received notification of their selection. CMS anticipates a total of 25 plan organizations to be audited in this cycle.

Regulatory Compliance 52

Regulatory Compliance Compliance Medicare Medicare 52

HIT Consultant

JANUARY 26, 2023

This pivotal moment provides an opportunity for health plans to adopt advanced technologies that not only ensure regulatory compliance but enable more strategic care management. Prior to joining Cohere, she was a senior advisor to Administrator Seema Verma at the Centers for Medicare & Medicaid Services.

Regulatory Compliance 52

Regulatory Compliance Medicare Medicare Medicaid 52

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 Medical Billing Outsourcing Regulatory Compliance 52

MedTrainer

JULY 12, 2023

Regulatory Compliance. Organizations like The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration (FDA), and Occupational Safety and Health Administration (OSHA) require incident reporting and response documentation as part of regulatory compliance.

Compliance 52

Compliance Regulatory Compliance FDA Medicaid 52

MedTrainer

JULY 12, 2023

Regulatory Compliance. Organizations like The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration (FDA), and Occupational Safety and Health Administration (OSHA) require incident reporting and response documentation as part of regulatory compliance.

Compliance 52

Compliance Regulatory Compliance FDA Medicaid 52

Healthcare IT Today

DECEMBER 17, 2023

Business process management company Sagility launched its Utilization Management as a Service offering , which aims to help providers with CMS regulatory compliance. Pair Team expanded into seven more California counties ; the company provides virtual primary care for Medicaid beneficiaries.

Hospitals 94

Hospitals Nurses Compliance Regulatory Compliance 94

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

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

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

Healthcare Blog

APRIL 13, 2023

As hospitals have become increasingly complex organizations, effective governance, risk, and compliance (GRC) strategies have become essential for ensuring patient safety and regulatory compliance. Improve GRC in Your Facility GRC strategies are essential for ensuring hospital patient safety and regulatory compliance.

Governance 40

Governance Compliance Hospitals Regulatory Compliance 40

Healthcare Blog

AUGUST 23, 2023

Strategies Healthcare Organizations Can Use to Promote Ethical Behavior in Compliance Ensuring ethical practices in healthcare compliance is essential to corporate health and the integrity of your organization. Use the following strategies to promote ethical behavior in regulatory compliance. 2022, December 5).

Compliance 56

Compliance Nurses Regulatory Compliance Medicaid 56

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 Medical Billing Outsourcing ACA 52

Healthcare IT Today

JUNE 7, 2023

However, it seems that the protracted regulatory promulgation process that preceded the publication of HTI-1 was not used by ONC to push back various deadlines originally included in the proposed rule, resulting in suggested timelines that would be insufficient to complete sizable development work.

FDA 77

FDA Compliance Regulatory Compliance Medicaid 77

Medisys Compliance

NOVEMBER 10, 2023

Plastic surgeons and medical billing companies can form a valuable partnership to enhance coding accuracy, improve documentation review, streamline claim processing, ensure regulatory compliance, and maximize reimbursement opportunities.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Regulatory Compliance Compliance 59

Innovaare Compliance

FEBRUARY 14, 2022

Operational teams—such as the Member Services Department and the Appeals & Grievances Department—have significant compliance regulations, so they must know to maintain compliance. This includes CMS regulations for Medicare Plans, regulations for Commercial Plans and Medicaid regulations for state plans.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

MedTrainer

APRIL 20, 2023

Providers need a strong compliance program to inform the creation of compliance checklists. The Seven Core Compliance Program Requirements The Centers for Medicare & Medicaid Services (CMS) criteria promote an effective compliance program in healthcare organizations.

Compliance 52

Compliance Compliance Officers Regulatory Compliance Regulations Compliance 52

Medisys Compliance

MAY 4, 2023

Regulatory compliance: Oncology practices must comply with various regulatory requirements, including HIPAA, CMS, and payer-specific guidelines. Compliance failures can result in penalties and fines. Insurance denials can be common, requiring appeals and resubmissions.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medical Billing Services Compliance 52

Innovaare Compliance

NOVEMBER 29, 2023

On October 13, 2023, the Centers for Medicare & Medicaid Services (CMS) published the Readiness List for CY 2024. The Readiness List is comprehensive and touches on all aspects of administering a Medicare Advantage plan (MA), a Prescription Drug Plan (PDP), an 1876 Cost Plan, and a Medicare-Medicaid Plan (MMP).

Medicare 52

Medicare Medicare Compliance Medicaid 52

Healthcare IT Today

JANUARY 8, 2024

Streamlining Regulatory Compliance with AI Automated Compliance Monitoring: In 2024, AI is predicted to automate the monitoring of regulatory compliance in drug development, efficiently tracking changes in global regulatory requirements and ensuring adherence to these evolving standards.

Pharmaceutical Industry 83

Pharmaceutical Industry Due Diligence Compliance Regulatory Compliance 83

Healthcare Law Today

JANUARY 20, 2022

The entity is also prohibited from billing Medicare or, possibly, Medicaid for such referrals. Given the multiples at which these practices will trade, vetting critical legal issues is crucial to ensure buyers of legal and regulatory compliance and maintaining value for the prices to be paid.

Compliance 52

Compliance Medicare Medicare COVID-19 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. Enrollment requirements will be established by the secretary (amendments to IC 12-15-11-5).

Licensing 52

Licensing Nurses Compliance Medicaid 52

Health Care Law Brief

JANUARY 19, 2022

Medicare and Medicaid have had similar price transparency rules, but now those rules will apply across all lines of business in New York. Disclosure requirements.

Prescription Drug Pricing 52

Prescription Drug Pricing Licensing Compliance Medicaid 52

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

Florida Health Care Law Firm

FEBRUARY 22, 2022

That type of arrangement is equivalent to buying a referral, which is unlawful, violates antikickback statutes, and will result in false claims being filed with Medicare, Medicaid, Tricare, ChampVA, or others. DME companies that hire telemarketers cannot pay these telemarketers to pay telehealth providers. genetic testing).

Medicare 52

Medicare Medicare Telemedicine Fraud 52