Medisys Compliance

JANUARY 30, 2023

Medicare and Medicaid: Medicare and Medicaid are government-funded healthcare programs that provide coverage to millions of Americans. We work closely with our clients to ensure that their systems and processes are in compliance with these regulations.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

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

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

Innovaare Compliance

NOVEMBER 29, 2023

On October 13, 2023, the Centers for Medicare & Medicaid Services (CMS) published the Readiness List for CY 2024. This has been a very useful tool for Medicare Advantage Organizations (MAO) to check their readiness to fulfill requirements in the new contract year.

Medicare 52

Medicare Medicare Compliance 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. Flexibilities regarding patient-specific nursing care plans.

Public Health 52

Public Health COVID-19 COVID-19 Vaccine Medicare 52

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

YouCompli

MARCH 22, 2023

Department of Health and Human Services Office of Inspector General (OIG) has expressed concerns about UDT billing. According to the OIG, prior error rate testing has suggested an improper payment rate of almost 30% for Medicare. In February 2023, the OIG released an audit report about UDT.

Overpayments 52

Overpayments Overpayment Compliance Medicare 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

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 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

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

DECEMBER 7, 2023

Healthcare Facility Standards In Idaho, the Bureau of Facility Standards plays a key role that is particularly relevant for healthcare executives and compliance officers. For healthcare executives and compliance officers, thorough understanding and adherence to the Bureau’s standards is required.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Fraud 52

Fraud Medicare Medicare Compliance 52

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Fraud 52

Fraud Medicare Medicare Compliance 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

JANUARY 31, 2024

The OIG’s voluntary, non-binding guidance documents help healthcare organizations and their compliance teams to self-monitor and prevent fraud, waste, and abuse. In 2023, the OIG provided updated guidance with a promise of updates to industry-specific guidance in 2024.

Compliance 52

Compliance Fraud Governance ACA 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

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

AIHC

MAY 7, 2024

References AIHC Auditing for Compliance - Basics of RCA and HFMEA are taught in the AIHC online Certified Healthcare Auditor (CHA) program Ahmed. Medicare NCCI FAQ Library | CMS. She is serves as a subject matter expert and volunteer on the Education Committee for the American Institute of Healthcare Compliance. ProPublica.

Compliance 52

Compliance Compliance Officers Fraud Doctors 52

YouCompli

NOVEMBER 30, 2022

Additionally, we are subject to regulatory guidance from our Medicare Administrative Contractor. We can have a designated compliance officer and have open lines of communication. We’re offering an SBAR workshop in early 2023. operational, financial, and reputational risks. Name your regulators. of the required elements.

Regulatory Compliance 52

Regulatory Compliance US Department of Health and Human Services Compliance Compliance Officers 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 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

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. Extra Time. Areas Addressed in 2019 Proposed Rule.

Nurses 40

Nurses COVID-19 Compliance Medicare 40

YouCompli

NOVEMBER 9, 2022

The OIG has already released some audit findings and expect to fully complete this work plan item in 2023. The OIG concluded the practice complied with Medicare billing requirements for 36 critical care services but did not comply for the remaining 56. There were two primary reasons for not meeting the Medicare billing requirements.

Compliance 52

Compliance Medicare Medicare 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

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

MARCH 31, 2023

in Financing for Medical Office Building in Utica, New York Jacobi hospital saw 20% of its nurses quit in 2022. in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? Mississippi lawmakers approve $104M for hospitals, but is it enough?

US Department of Health and Human Services 40

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

Hall Render

AUGUST 25, 2023

Black’s Eye Associates Jeremy Hall named ARH regional CEO Norton Healthcare moves to take full ownership of two southern Indiana hospitals Norton Healthcare acquiring full ownership of Clark Memorial Health and Scott Memorial Health Report: Waystar preps to to go public with $8 billion IPO St.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 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

YouCompli

JANUARY 25, 2023

Once you decide to admit someone, you have the overlay of Medicare requirements that impact the ability to discharge the patient.” – Joshua Abrams Safe, Appropriate, and Achievable Discharge Plans While the standard for discharge plans is “safe and appropriate,” Abrams also adds “achievable.”

Compliance 40

Compliance Hospitals Compliance Officers Nurses 40

HIT Consultant

JUNE 30, 2023

appoints Faith Zaslavsky as its new Chief Executive Officer. Zaslavsky, who has served as the Company’s President and Chief Operating Officer since December 2022, will assume this role effective June 26, 2023, replacing Mick Ruxin, M.D., who will transition to Theralink’s Chief Medical Officer.

Medicare 52

Medicare Medicare Compliance Officers Compliance 52

Hall Render

AUGUST 26, 2024

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. hospitals Gov. hospitals Gov.

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

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. hospitals Gov. hospitals Gov.

US Department of Health and Human Services 40

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

Hall Render

MARCH 24, 2023

hospitals spent $1.5B on temporary labor in 2022 Mass. Luke’s Health System rolls out Meditech’s ‘smart’ pump integration DOJ dismisses appeal challenging UnitedHealth-Change Healthcare’s $7.8B

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40