MedTrainer

JANUARY 10, 2024

It may seem a little early to do some spring cleaning, but not when it comes to compliance! It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. Release of Industry-Specific Compliance Program Guidance (ICPG) is anticipated in 2024.

Compliance 94

Compliance Fraud HIPAA Compliance Officers 94

Verisys

MAY 3, 2023

7 Core Elements of Healthcare Compliance Plan and How to Measure Them Healthcare compliance regulations are complex and ever-changing, but are an essential part of any healthcare organization’s effort to provide safe, high-quality care for patients. Measuring effectiveness: Who is your designated compliance officer?

Compliance 52

Compliance Compliance Officers ADA Governance 52

HIPAA Journal

JANUARY 30, 2023

These groups cover privacy and HIPAA compliance best practices, HIPAA breach trends, and HIPAA enforcement initiatives and breach trends. This will be followed by the preconference basic training day on March 2, 2023.

US Department of Health and Human Services 85

US Department of Health and Human Services HIPAA Compliance Medicaid 85

C&M Health Law

DECEMBER 18, 2023

The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) published the General Compliance Program Guidance (GCPG) on November 6, 2023. The GCPG provides updated descriptions of the seven elements of an effective compliance program that health care entities have long relied upon.

Compliance 52

Compliance Compliance Officers Governance Overpayments 52

MedTrainer

SEPTEMBER 10, 2024

Two recent examples are the HIPAA Privacy Act changes in 2024 , which requires training to be completed by December, and the MATE Act passed in 2023 , which includes a one-time eight-hour training requirement. If compliance officers were not up-to-date on these additional requirements, the entire staff could be out of compliance.

Compliance 52

Compliance Compliance Officers HIPAA Medicare 52

MedTrainer

DECEMBER 7, 2023

The Medicaid and Health program of Idaho provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities in the state, offering a range of medical and health-related services.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

MedTrainer

NOVEMBER 14, 2023

Compliance officers, human resource leaders, credentialing teams, and administrators are all asking themselves these critical questions. While payments could take longer, so might Medicare/Medicaid enrollments for organizations, providers, and patients. But what does this mean for your healthcare business?

Governance 52

Governance Medicaid Medicaid Medicare 52

MedTrainer

NOVEMBER 27, 2023

Managing healthcare compliance in Ohio presents a unique set of challenges for compliance officers, healthcare professionals, and administrators. Organizations need to successfully navigate the regulatory landscape in order to provide efficient and ethical healthcare services, and to avoid consequences for non-compliance.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

YouCompli

MARCH 29, 2023

As a result, the COVID-19 public health emergency (PHE) declared under Section 319 of the Public Health Service act, is expected to end officially on May 11, 2023. HHS made this announcement on February 9, 2023 , along with the publication of a transition roadmap.

Public Health 52

Public Health COVID-19 COVID-19 Vaccine Medicare 52

Compliancy Group

JUNE 17, 2024

The Centers for Medicare & Medicaid Services (CMS) has identified that a significant number of improper payments are issued every year. In 2023 alone, the improper payment rate reported by CMS for Part D payments alone was nearly 4%, an increase from 2022. The most common source of error is funds paid to the wrong entity.

Compliance 59

Compliance Compliance Officers Medicaid Medicaid 59

MedTrainer

MARCH 28, 2024

This is one of seven components recommended in the OIG’s compliance guidelines. In large healthcare organizations, a compliance officer is typically responsible, however, in smaller organizations, such as physician practices, a case could be made for the entity’s compliance contact to be in one of several different roles.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

NOVEMBER 30, 2023

The Missouri Department of Social Services (DSS) is the state agency responsible for providing essential support and services to vulnerable individuals and families, including child welfare, assistance programs, and oversees the MO HealthNet Division , which is the state’s Medicaid program.

Compliance 52

Compliance Compliance Officers Hospitals Public Health 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

MedTrainer

JUNE 29, 2023

The Office of Inspector General (OIG) can impose civil monetary penalties for each Stark Law violation. As of 2023, the penalty amount is up to $27,018 for each service provided in violation of the law, along with an assessment of up to three times the amount claimed for the services. Exclusion from Federal Healthcare Programs.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

MedTrainer

FEBRUARY 12, 2024

Knowingly or falsely claiming monies from federal programs such as Medicare and Medicaid has cost healthcare entities $72B since 1986. How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims? government collected $2.2B

Compliance 52

Compliance Fraud Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

The Division of Health Benefits administers the state’s Medicaid program, which provides essential healthcare coverage to eligible individuals and families. Medicaid Expansion Law In March 2023, North Carolina passed House Bill 76, “Access to Healthcare Options,” an initiative to expand Medicaid.

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

MedTrainer

SEPTEMBER 8, 2023

Covenant Healthcare Stark Law Settlement (2023) In 2023, Covenant Healthcare System reached a settlement agreement with the Department of Justice (DOJ) to pay more than $69 million to resolve allegations that it violated Stark Law. Many healthcare facilities rely on reimbursements from government programs such as Medicare and Medicaid.

Compliance 52

Compliance HIPAA Medicaid Medicaid 52

MedTrainer

NOVEMBER 20, 2023

Ensuring adherence to licensing requirements, the Florida Agency for Health Care Administration oversees Medicaid, coordinating essential healthcare access to vulnerable populations. Regulations Unique to Florida To meet the standards of healthcare compliance in Florida, there are a few additional regulations.

Compliance 52

Compliance Licensing Regulatory Compliance Medicaid 52

American Medical Compliance

FEBRUARY 15, 2023

The Centers for Medicare and Medicaid Services (CMS) require FWA training. In compliance with the FWA Training Certificate requirement, first-tier companies must ensure that their downstream entities undergo CMS FWA Training. Abuses create a variety of issues, including: Wasteful Medicaid and Medicare program expenses.

Fraud 52

Fraud Medicare Medicare Compliance 52

American Medical Compliance

FEBRUARY 15, 2023

The Centers for Medicare and Medicaid Services (CMS) require FWA training. In compliance with the FWA Training Certificate requirement, first-tier companies must ensure that their downstream entities undergo CMS FWA Training. Abuses create a variety of issues, including: Wasteful Medicaid and Medicare program expenses.

Fraud 52

Fraud Medicare Medicare Compliance 52

MedTrainer

DECEMBER 7, 2023

The New Hampshire Medicaid (Medical Assistance) program within DHHS provides medical assistance to eligible low-income residents, offering a range of healthcare services to support their health and well-being. Two significant changes were made in 2023.

Compliance 52

Compliance Licensing Public Health Medicaid 52

AIHC

NOVEMBER 6, 2023

Consequences can include public disclosure of the provider’s violation, administrative reprimands, and termination of Medicare and Medicaid billing privileges by being listed on the Office of Inspector General (OIG) Exclusions List.

HIPAA 59

HIPAA Compliance Governance Health Insurance 59

AIHC

NOVEMBER 6, 2023

Consequences can include public disclosure of the provider’s violation, administrative reprimands, and termination of Medicare and Medicaid billing privileges by being listed on the Office of Inspector General (OIG) Exclusions List.

HIPAA 52

HIPAA Compliance Governance Health Insurance 52

MedTrainer

NOVEMBER 14, 2023

In Virginia, healthcare compliance may differ in Medicaid policies, telehealth regulations, scope of practice for healthcare professionals, certificate of need (CON) laws, and specific state mandates related to healthcare reporting and licensing.

Compliance 52

Compliance Licensing Governance Hospitals 52

MedTrainer

NOVEMBER 5, 2023

Credentialing Compliance in Colorado The Colorado Medical Board oversees medical credentialing and licensing within the state. Until March 2023, providers seeking medical credentialing in Colorado were required to submit a uniform application (Colorado Health Care Professionals Credentials Application).

Compliance 52

Compliance Licensing Informed Consent Public Health 52

MedTrainer

NOVEMBER 20, 2023

The Texas HHS oversees regulations for Medicare- and state Medicaid-funded services. Regulations Unique to Texas To meet the standards of healthcare compliance in Texas, there are a few additional regulations. Billing Requirements Texas Senate Bill 490 went into effect September 1, 2023.

Compliance 52

Compliance Licensing Public Health Governance 52

MedTrainer

NOVEMBER 29, 2023

The Indiana Family and Social Services Administration (FSSA) is a state’s Medicaid agency that provides essential support and services, such as healthcare, mental health, and social services, to improve the welfare and quality of life for families and individuals in Indiana.

Compliance 52

Compliance Licensing Governance Public Health 52

Hall Render

JULY 18, 2022

The Centers for Medicare & Medicaid Services (“CMS”) has given itself an extra year to review and assess skilled nursing facility proposed regulations issued in 2019. The notice extends the timeline to finalize the provisions until July 18, 2023. Background. Areas Addressed in 2019 Proposed Rule.

Nurses 40

Nurses COVID-19 Compliance Medicare 40

Provider Trust

FEBRUARY 3, 2023

In a recent webinar, ProviderTrust took a look at impactful healthcare trends to monitor in 2023 and beyond. According to a January 2023 Washington Post article , nurses across California, Oregon, Michigan, and Minnesota have also threatened to protest or have already gone on employment strike.

Compliance 52

Compliance Fraud Nurses Telemedicine 52

AIHC

FEBRUARY 16, 2024

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. Within item #5 are directives from the OIG related to incentives.

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

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. Within item #5 are directives from the OIG related to incentives.

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Hall Render

AUGUST 25, 2023

NATIONAL AHA shares proposals for drug shortage legislation with House committee America’s biggest hospital landlord sees deals souring Babylon Health files for bankruptcy Bankruptcies mounting in troubled nursing home industry Calls grow for national patient safety board: 3 leaders weigh in CMS details plan to allow Part D beneficiaries to pay (..)

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

MARCH 31, 2023

Luke’s prepares to close downtown street, years after contentious approval Idaho legislators pass contentious bill that adds clarification language to abortion ban Idaho’s first pediatric residency program hopes to increase number of professionals in the field St.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes COVID-19 Nurses 40

Hall Render

DECEMBER 29, 2023

NATIONAL 4 largest healthcare data breaches of 2023 Anesthesia practices sue CMS over reimbursement method Antitrust enforcements hit a high in 2022, with health deals impacted ASCs face leadership exodus CMS floats appeals process over observational stays CMS proposes additional Medicare appeals processes FTC eyes healthcare mergers, report shows (..)

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses COVID-19 40

Hall Render

MARCH 24, 2023

Sanders pushes funding boost for rural health care Struggling to survive, the first rural hospitals line up for new federal lifeline ALABAMA AARP report puts spotlight on caregiving issues, expenses in Alabama All of Us Research Program launching new enrollment location in Dothan Local partnership to provide cancer screening for rural patients Medical (..)

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

AUGUST 26, 2024

hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., Vincent Heart Center ranked No. 1 in Indiana, No. million impact on local economy Proposal: Nursing home would have 10-plus years to pay $1 million owed to the state of Iowa This Des Moines hospital was rated 5 stars by CMS.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

AUGUST 23, 2024

hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., Vincent Heart Center ranked No. 1 in Indiana, No. million impact on local economy Proposal: Nursing home would have 10-plus years to pay $1 million owed to the state of Iowa This Des Moines hospital was rated 5 stars by CMS.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40