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These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

The Department of Health and Human Services once again (for the ninth time) extended the public health emergency this past month , stretching it beyond mid-July. But sooner or later, that provision of the Public Health Service Act will draw to a close. We spoke recently with Allison M.

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Pennsylvania Man Excluded from All Federal Healthcare Programs for 22 Years 

Healthcare Compliance Blog

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. HHS-OIG will continue to work with the US Attorney’s Office to ensure the integrity of the Medicare Trust Fund.”.

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Compliance Risks Associated with Outlier Payments 

YouCompli

Compliance officers can help protect revenue and reduce the risk of penalties by collaborating with the Finance and Reimbursement departments to navigate the dynamics of outlier payments and prospective repayment. Leverage OIG reports to protect healthcare revenue. Price increases can sometimes result in inappropriate outlier payments.

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Avoiding “Gotcha” Moments in Compliance 

YouCompli

Unfortunately, with a title like “compliance officer,” we have some image issues to overcome if we want our healthcare leaders to see us more like a business partner and less like an obstacle. Let’s imagine someone is conducting an audit involving the review of medical-necessity documentation for physical therapy services.

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Improving Patient Care With a “Prevent, Detect, Report” Strategy  

YouCompli

Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic. For example, they can describe how to read a billing statement and identify services or supplies that were not provided.

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Medicare Audit Claims University of Miami Hospital Owes Government $3.7 Million

The Health Law Firm

Board Certified by The Florida Bar in Health Law The University of Miami Hospital allegedly owes Medicare $3.7 This is according to an audit report of the hospital’s billing practices that found the hospital allegedly overbilled the health care program in 2009 and 2010. Indest III, J.D.,

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Health Provider News

Hall Render

NATIONAL 3 things to expect from the pharmaceutical supply chain in 2024 Absence of AI hospital rules worries nurses American Academy of Dermatology votes to keep its diversity policies after anti-DEI proposal Are digital health partnerships replacing M&A? From -6.8%