AIHC

JUNE 14, 2024

Part 3 in a series of articles to support World Elder Abuse Awareness Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS of the American Institute of Healthcare Compliance ( AIHC ), a non-profit healthcare education organization. These scams are outlined in more detail below.

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MedTrainer

JULY 3, 2024

Determining the necessary compliance training and ensuring your staff stays ahead of these requirements can be complex without comprehensive home health training. In this article, we’ll explore the requirements for home health training and ideas for simplifying its delivery.

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MedTrainer

JULY 8, 2024

However, staffing challenges and limited resources may make adhering to compliance rules difficult without physician office training programs. In this article, we’ll explore the requirements for physician office training and ideas for simplifying its delivery.

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MedTrainer

APRIL 22, 2024

Creating and using a supplier compliance checklist ensures vendors meet regulatory requirements and are trusted partners in managing sensitive information. In this article, I’ll discuss why supplier compliance is as critical as legal and regulatory adherence for healthcare organization employees.

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MedTrainer

JULY 29, 2024

Healthcare compliance is complicated for organizations of any size. However, the complexities grow exponentially for large or enterprise organizations with hundreds or thousands of employees who must complete and pass rigorous compliance training. What Is Corporate Compliance Training?

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Healthcare IT Today

MAY 5, 2023

The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient. In 2021, a U.S.

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Compliancy Group

JANUARY 3, 2024

This article discusses the issues related to medical billing compliance policy and the steps for providers to maintain financial integrity and adherence to all requirements. Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices.

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MedTrainer

APRIL 8, 2024

As a healthcare professional, it is vital to maintain compliance with the 629 legal and regulatory requirements that govern the delivery of quality care. One effective tool to achieve this is through internal healthcare compliance audits. What Is an Internal Healthcare Compliance Audit?

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MedTrainer

JULY 31, 2024

Healthcare organizations of all sizes and types are increasingly adopting governance, risk, and compliance (GRC) frameworks to address the industry’s complex regulatory landscape and evolving challenges. Implementing GRC for healthcare has substantial benefits for healthcare leaders. What Is Healthcare GRC?

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YouCompli

DECEMBER 11, 2023

The long-awaited, new OIG General Compliance Program Guidance (GCPG) has been released, all 91 pages of it. If you have not viewed it yet, click here: [link] This release is the first major compliance guidance document the OIG has shared in many years. The compliance officer should either report directly to the CEO or the Board.

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Med Law Blog

MARCH 18, 2024

Attached are links to the remarks of Attorney General Garland and Deputy Attorney General Monaco.

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AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

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MedTrainer

MARCH 8, 2024

Long-term care facilities are among the most regulated in healthcare, making compliance challenging and training critical. In this article, we’ll explore the requirements for long-term care training as well as ways to ideas to simplify the delivery of training.

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AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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Compliancy Group

DECEMBER 8, 2023

Compliance is a critical aspect of the healthcare industry. However, there are several high-risk areas where compliance issues can arise, potentially leading to legal troubles and compromised patient safety. Billing and Coding Practices Billing and coding errors are another area where compliance issues can arise.

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Medisys Compliance

JUNE 23, 2024

Introduction In the ever-evolving landscape of healthcare, compliance with the Health Insurance Portability and Accountability Act (HIPAA) is crucial for protecting patient information and maintaining trust. Enacted in 1996, HIPAA is a federal law designed to safeguard patient health information (PHI) from fraud and abuse.

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Compliancy Group

OCTOBER 2, 2023

In the fast-paced world of healthcare, compliance reporting plays a vital role in ensuring accountability and transparency. This article will explore the significance of compliance reporting in healthcare and how it helps organizations maintain data integrity and mitigate risks. What is Compliance Reporting in Healthcare?

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AIHC

SEPTEMBER 25, 2024

Reviewing the Office of Inspector General's (OIG) enforcement actions is important for compliance officers because it can help them understand the OIG's focus and priorities, and how to comply with federal health care laws and regulations. The OIG and prosecutors look for evidence of “lessons learned”, as outlined in an the U.S.

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Compliancy Group

MARCH 25, 2024

In today’s complex healthcare landscape, compliance is crucial. A healthcare compliance due diligence checklist is one essential tool that can help organizations in their quest for compliance. What is a Healthcare Compliance Due Diligence Checklist? What is a Healthcare Compliance Due Diligence Checklist?

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AIHC

MAY 24, 2022

Once your suspicions have been reported to the Compliance Officer, were you asked to partake in evidence gathering during the investigation? The content of this article is for educational purposes and not intended as consulting or legal advice. Have you ever uncovered erroneous or potentially fraudulent evidence?

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MedTrainer

MAY 31, 2024

An effective healthcare compliance training program mitigates risks, enhances patient care, and keeps the organization compliant with all federal and state regulations that require education. What is Healthcare Compliance Training? This keeps compliance at the forefront of everyone’s mind.

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YouCompli

JULY 20, 2022

Anstine is a compliance professional and consultant in Colorado. He is writing a series of articles on compliance culture for the YouCompli blog. This post looks at engaging the compliance committee. Within the business of healthcare, we talk a lot about a culture of compliance.

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Hall Render

NOVEMBER 10, 2023

Department of Health and Human Services (“HHS”) issued new General Compliance Program Guidance (“GCPG”) for members of the health care compliance community and other health care stakeholders. Key Highlights of the GCPG Much of what is covered in the GCPG is not new to the health care compliance industry.

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YouCompli

DECEMBER 19, 2023

Last month, the Office of Inspector General (OIG) published a new, user-friendly, 91-page General Compliance Program Guidance (GCPG). HIPAA Privacy and Security Rules (page 30): In bold print, the OIG recommends that compliance with Privacy, Security and Breach Notification Rule requirements be included in ALL risk assessments.

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YouCompli

MAY 25, 2022

Anstine, JD is a compliance professional and consultant in Colorado. He is writing a series of articles on compliance culture for the YouCompli blog. This post establishes a working definition of compliance culture and puts it in the context of overall healthcare priorities. They’d likely still be in business today.

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YouCompli

NOVEMBER 29, 2023

“As previous OIG compliance guidance(s) are retired to ‘archival’ status, we all should recognize that the original guidance may have been the most important document ever written for healthcare compliance professionals.” — Roy Snell In 1998, the Office of Inspector General (OIG) issued its first General Compliance Program Guidance (GCPG).

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Healthcare IT Today

NOVEMBER 19, 2020

The following is a guest article by Donna Thiel, Chief Compliance Officer at ProviderTrust. Although there may be numerous benefits to using telehealth services, patients and providers should also consider the substantial telehealth risks involved.

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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. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

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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. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

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Hall Render

SEPTEMBER 15, 2022

This study comes on the heels of a recent Press Release issued July 20, 2022 (“Press Release”), in which the Department of Justice (“DOJ”) announced criminal charges against 36 defendants in 13 federal districts across the United States largely alleging fraud in the telemedicine space. Inspector General Christi A.

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Compliancy Group

FEBRUARY 7, 2024

CMS UPIC audits are designed to identify and prevent fraud, waste, and abuse within Medicare and Medicaid, ensuring that federal funds are used appropriately and that the services billed for are actually provided and are medically necessary. Given their significant impact, healthcare organizations must take UPIC audits seriously.

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AIHC

JUNE 6, 2023

According to Investopedia’s article “ Understanding Machine Learning: Uses, Example ,” machine learning is the concept that a computer program can learn and adapt to new data without human intervention and is a field of artificial intelligence that keeps a computer’s built-in algorithms current regardless of changes in the worldwide economy.

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Hall Render

SEPTEMBER 12, 2022

Healthsouth of Sarasota Limited Partnership, et al , the Eleventh Circuit held that for a plaintiff to qualify as engaging in “protected activity,” the plaintiff must demonstrate that they had both a subjectively reasonable belief of fraud and an objectively reasonable belief of fraud. Background. 3730(h)(1). Practical Takeaways.

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AIHC

JUNE 6, 2023

According to Investopedia’s article “ Understanding Machine Learning: Uses, Example ,” machine learning is the concept that a computer program can learn and adapt to new data without human intervention and is a field of artificial intelligence that keeps a computer’s built-in algorithms current regardless of changes in the worldwide economy.

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Healthcare IT Today

JUNE 29, 2023

The following is a guest article by Isaac Smith, Billing, Coding, and Reimbursement Specialist at Medcare MSO ASCs are types of medical facilities that are subject to stringent regulations. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. ASC billing compliance has many benefits.

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YouCompli

JANUARY 4, 2022

Ross addressed the Massachusetts Health and Hospital Association’s Healthcare Legal Compliance Forum in December 2021. . They provide great insight for Compliance practitioners. YouCompli sponsored MHA’s 2021 Healthcare Legal Compliance Forum in 2021. Subscribe to get the latest articles about healthcare regulatory changes.

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Verisys

APRIL 13, 2023

Harm isn’t just in the form of medical errors but can also be associated with healthcare fraud. In 2016, an article published by the British Medical Journal (BMJ) listed medical errors as the third cause of death in the United States. Up to 10% of federal healthcare funding is lost to fraud, waste, and abuse.

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