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CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes

Healthcare Law Blog

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

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How Serious are OIG Exclusions? Key Insights into the Fraud Risk Spectrum

Provider Trust

Luckily for all us, there’s a spectrum–and it was created with visibility and safety in mind. Department of Justice (DOJ), the U.S. And when patient care and reimbursements are on the line, even one bad actor can put an entire organization’s reputation in jeopardy. How the OIG Finds & Prosecutes Healthcare Fraud.

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The HIPAA Definition of Covered Entities Explained

HIPAA Journal

The HIPAA definition of Covered Entities is generally explained as health plans, health care clearinghouses, and health care providers that conduct electronic transactions for which the Department of Health and Human Services (HHS) has developed standards. 2) A health care clearinghouse. (3)

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HIPAA Compliance Guide: All Your Questions Answered

Total HIPAA

We explain every facet of HIPAA, including information about who needs to be HIPAA compliant , who enforces HIPAA , what happens when you violate HIPAA , and what you must do to become and remain HIPAA compliant. Your HIPAA compliance plan will change as your staff, IT department, and business grows or evolves.

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SQA Regulatory Surveillance Summary | Monthly Update 2023 – January

SQA

Relevant matters are hereby announced as follows: As of 01 December 2022, the Electronic Certificates of Documentation for Export of APIs to the EU and Certificate of a Pharmaceutical Product will be put into use. Efforts should be made to promote and guide the use of electronic certificates.

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The Cobra Effect & Enforcing Compliance Standards

AIHC

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

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The Cobra Effect & Enforcing Compliance Standards

AIHC

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”