Healthcare IT Today

OCTOBER 26, 2024

Each week, we’ll be providing a look back at the articles we posted and why they’re important to the healthcare IT community. Staying a step ahead of this type of fraud requires a proactive approach to real-tine auditing and coding, noted David Lareau at Medicomp Systems. Welcome to our Healthcare IT Today Weekly Roundup.

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Ransomware Fraud Licensing Nurses 95

Hall Render

MARCH 4, 2025

Department of Health and Human Services (HHS) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursing home members of the health care compliance community. Medical Directors in Nursing Homes 42 CFR 483.70(g) See 42 C.F.R. See 42 C.F.R.

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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.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Hall Render

NOVEMBER 21, 2023

The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. This category of individuals is sometimes called a “fraud alert employee.” Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C.

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Fraud Compliance 72

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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Compliance COVID-19 Compliance Officers Ransomware 92

Healthcare IT Today

MARCH 26, 2025

The following is a guest article by Josh Rosaasen , Chief Operating Officer at Locke Bio The rise of direct-to-consumer ( DTC ) telehealth services has revolutionized how patients access medical care and prescriptions. Telehealth providers must align with organizations like LegitScript , which certifies compliance with regulatory standards.

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FDA Compliance Licensing Fraud 52

Healthcare IT Today

FEBRUARY 13, 2025

The following is a guest article by Richard Caralli , Senior Cybersecurity Advisor at Axio Cybersecurity regulations often emerge in response to major incidents. The proposed changes aim to modernize regulations and impose stricter compliance measures to address the growing cybersecurity challenges.

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Compliance HIPAA Ransomware Fraud 59

Medisys Compliance

JANUARY 16, 2025

While some flexibilities have been made permanent, providers should stay updated on the latest CMS guidelines to ensure compliance. Compliance with Medicare Regulations Compliance is crucial to avoid audits and penalties. Avoid fraud: Ensure billing accurately reflects services rendered. All rights reserved.

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Medicare Medicare Medical Billing Outsourcing Fraud 59

Healthcare IT Today

FEBRUARY 7, 2025

The following is a guest article by Muhammad Shujja, Digital Marketing Lead at AltuMED Artificial Intelligence is making waves by redefining processes and streamlining operations in the evolving healthcare industry. This article examines how AI is changing medical billing. And it is just the beginning.

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MedTrainer

JANUARY 21, 2025

Todays healthcare organizations face mounting pressures to keep impeccable compliance records while managing increasingly complex operations. Proactivity in the form of continuous OIG exclusion list monitoring is key to minimizing risk, maintaining compliance, and avoiding costly mistakes.

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Compliance Fraud Regulatory Compliance Medicare 52

AIHC

FEBRUARY 24, 2025

Part 2: When Criminal Behavior Infiltrates Your Audit Program Written by Carl J Byron , CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret) We Recommend Reading Part 1 Fraud Indicators and Red Flags When Audit Managers Knowingly Skew Audit Results as this article is Part 2, the rest of the story.

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Healthcare IT Today

MARCH 27, 2025

The following is a guest article by Luke Rutledge, President at Homecare Homebase The allure of AI in healthcare is undeniable. The Risks: Ethics, Bias, and Compliance Challenges AI’s role in healthcare is evolving, but so are its associated challenges.

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Governance Compliance HIPAA Regulatory Compliance 64

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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Fraud Medicare Medicare Overpayments 72

Compliancy Group

JULY 10, 2024

Compliance with healthcare regulations protects patients, safeguards employee safety, and maintains the security of electronic medical records (EMRs) and cyber networks. Ensuring compliance with critical regulations falls on the compliance officer. What Does a Compliance Officer Do?

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Healthcare IT Today

DECEMBER 26, 2024

Check out our community’s Healthcare Cybersecurity predictions: Bill Murphy, Director of Security and Compliance at LeanTaaS As we enter 2025, AI is revolutionizing cyber threats in concerning ways. Recent incidents involving fake video calls and voice cloning demonstrate the technology’s potential for sophisticated fraud.

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US Department of Health and Human Services Ransomware Compliance Hospitals 93

AIHC

SEPTEMBER 3, 2024

Celebrating the Healthcare Compliance Officer The American Institute of Healthcare Compliance is recognizing healthcare Compliance Officers – hats off to you! The primary goal of a compliance officer is to mitigate risk. This involves investigating complaints and conducting internal auditing and monitoring for compliance.

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Compliance Officers Compliance Fraud Medicare 52

HIT Consultant

FEBRUARY 28, 2025

Bill Bruno, CEO at Celebrus Patient experience (PX) in healthcare is a crucial factor in engagement, compliance, and operational efficiency. Prioritizing Privacy and Compliance With increasing regulations around patient data, healthcare organizations must strike a careful balance between efficiency and security.

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Compliance Fraud 59

Hall Render

MARCH 11, 2025

Government fraud enforcement remains aggressive : Despite this ruling, health care providers should continue prioritizing compliance with Medicare and Medicaid billing regulations. Hall Render blog posts and articles are intended for informational purposes only.

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Medicare Medicare Governance Fraud 52

Healthcare IT Today

NOVEMBER 22, 2024

The following is a guest article by Cody Hall, Product Manager at Synology Cybercriminals are attacking our healthcare systems at an alarming rate. This data is incredibly valuable to attackers and can be used to steal identities, commit fraud, or be sold on the black market to the highest bidder.

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Ransomware Hospitals COVID-19 Compliance 72

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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Fraud Elder Abuse Governance Compliance 52

HIPAA Journal

JANUARY 20, 2023

This article is the second in a series that explores the benefits of HIPAA, focusing on some of the ways that HIPAA has benefited healthcare professionals. The first article in the series covered the benefits of HIPAA for healthcare organizations.

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HIPAA Fraud Compliance Health Insurance 122

Healthcare IT Today

DECEMBER 21, 2023

The following is a guest article by Mitchell Perry, VP Compliance & Security at Access In the ever-evolving landscape of healthcare IT in US healthcare frameworks, integrating electronic health records (EHRs) has become a cornerstone for providers. If healthcare providers fail to comply, the consequences can be costly.

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Records Management Regulatory Compliance Compliance HIPAA 128

Medisys Compliance

NOVEMBER 26, 2024

Skilled Nursing Facility (SNF) billing compliance is a critical aspect of healthcare revenue cycle management, ensuring accurate reimbursement and adherence to Medicare regulations. As healthcare providers navigate the complexities of SNF billing, maintaining compliance is essential to avoid penalties, denials, and financial losses.

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Compliance Medical Billing Outsourcing Medicare Medicare 52

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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Compliance Fraud Compliance Officers HIPAA 52

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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Compliance HIPAA Licensing Fraud 52

MedTrainer

FEBRUARY 7, 2025

Being prepared for a healthcare coding and compliance audit protects your healthcare organization from significant risks, such as fines, reimbursement issues, and potential loss of patient trust. This article will walk you through the steps so that your organization is healthcare coding and compliance audit-ready.

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Compliance Fraud Medicaid Medicaid 52

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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Fraud Compliance 52

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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Compliance HIPAA Fraud Health Insurance 52

MedTrainer

AUGUST 8, 2024

Why Additional Training Is Required for Medicare-Enrolled Providers Training helps providers understand and adhere to Medicare’s complex regulations and guidelines, essential for maintaining compliance. It also addresses Medicare Parts C and D compliance requirements.

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Medicare Medicare Compliance Medicaid 93

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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Compliance Compliance Officers Fraud Nurses 52

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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Compliance HIPAA Fraud Health Insurance 52

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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Compliance Fraud Medicare Medicare 52

Compliancy Group

DECEMBER 20, 2024

This HIPAA 2024 Year in Review article discusses these actions. On October 31, 2017, OCR initiated a compliance review of HVHS after the media reported that HVHS had experienced a ransomware attack. The settlement is the third ransomware settlement entered into by OCR.

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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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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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Compliance Compliance Officers Fraud Regulatory Compliance 52

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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Compliance US Department of Health and Human Services Regulatory Compliance Compliance Officers 52

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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