MedTrainer

FEBRUARY 7, 2024

The complex world of healthcare compliance demands a clear understanding of responsibilities. For those new to the role of compliance officer, the question often arises: “Who is responsible for compliance in healthcare?” Who is Responsible for Compliance in Healthcare?

Compliance 52

Compliance Compliance Officers Health Insurance Medicaid 52

MRO Compliance

JUNE 23, 2022

I recently wrote an article titled “Revenue Integrity: How to Reduce Costs and Retain Revenue” where I provided several tips on how to assess costs and resources and how to better prepare for audits to avoid denials. Maintaining and managing audits is one of the most time-consuming yet critical parts to ensure revenue integrity.

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Medicaid Medicaid Medicare Medicare 130

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.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

Medisys Compliance

APRIL 19, 2023

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

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Medicaid Medicaid Medical Billing Outsourcing Licensing 52

MRO Compliance

AUGUST 3, 2022

I recently wrote an article titled “Internal Audits Help Combat Payer Risk” where I described several keys for a smooth-running revenue cycle. By tracking and understanding audit activity, organizations can eliminate redundancy while filling in the gaps in revenue cycle compliance.

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Compliance Officers Medicare Medicare Compliance 130

Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare. As such, providers should prioritize billing compliance.

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Fraud Compliance Medicaid Medicaid 40

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

MedTrainer

MAY 21, 2024

With the odds of a person entering your healthcare facility dealing with a behavioral or mental health issue at about 20% , new and existing clinical providers must receive behavioral health compliance training to ensure patients receive the highest quality care. Training requirements vary by role and specific healthcare setting.

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Compliance Medicaid Medicaid HIPAA 52

MedTrainer

DECEMBER 4, 2023

Responsible healthcare providers and compliance professionals in each state of the United States must follow specific regulations, and achieving healthcare compliance in Kentucky is no exception. Regulations Unique to Kentucky To meet the standards of healthcare compliance in Kentucky , there are a few additional regulations.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

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Medicaid Medicaid Licensing Medical Billing Outsourcing 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

AIHC

NOVEMBER 12, 2024

This article addresses how these privacy rights extend beyond rules designated under HIPAA and States passing rules banning unauthorized pelvic exams. These revisions resulted from recent articles, media reports, and concerns from nurses, some physicians, and medical students opposing these exams. [3],[4]

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Informed Consent HIPAA Compliance Hospitals 98

MedTrainer

MAY 20, 2024

Understanding the differences in these requirements can ensure staff are taking the most relevant courses to maintain regulatory and accreditation compliance. In this article, we’ll explore the requirements for FQHC training and ways to simplify training delivery. However, meeting FQHC requirements is not as easy as it sounds!

Compliance 52

Compliance HIPAA Health Insurance Medicaid 52

MedTrainer

DECEMBER 7, 2023

To sail smoothly through the complex rules and requirements, you need a deep knowledge of the most essential aspects of healthcare compliance in Maine. A successful compliance program involves adaptability, comprehensive planning, and insight into key compliance factors, including credentialing requirements.

Compliance 52

Compliance Licensing Compliance Officers Medicaid 52

MedTrainer

AUGUST 9, 2024

Establishing measurable compliance objectives enables organizations to track their progress, identify areas for improvement, and mitigate risks before they escalate into significant issues. But how do you write healthcare compliance goals that accomplish this? We’ll tackle that question and more in this article.

Compliance 52

Compliance HIPAA Governance Health Insurance 52

MedTrainer

NOVEMBER 28, 2023

Healthcare providers, organizations, and compliance officers in Michigan State need to be aware of their state-specific laws and regulations in order to navigate compliance successfully. This article serves as a quick-reference guide for maintaining healthcare compliance in Michigan State.

Compliance 52

Compliance Licensing Public Health Compliance Officers 52

MedTrainer

JULY 11, 2024

Maintaining regulatory compliance has never been easy, and the pace of change isn’t slowing. In this article, I will share the impact of change on regulatory compliance and a few strategies to reduce disruption. Let’s start by defining regulatory compliance. What Is Regulatory Compliance?

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Regulatory Compliance Compliance Compliance Officers Hospitals 52

MedTrainer

DECEMBER 7, 2023

Healthcare compliance in New Mexico mirrors the state’s diverse culture, with unique regulations that differ from other states, such as credentialing documentation requirements for managed care organizations. New Mexico’s parity law requires insurers to cover telemedicine services to the same extent as in-person services.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

All healthcare organizations, along with their providers and compliance officers, must understand the requirements of each regulatory state agency that provides oversight. Robust, flexible, and reliable compliance programs must be developed to maintain compliance in Hawaii.

Compliance 52

Compliance Compliance Officers Licensing Medicaid 52

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 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

MedTrainer

DECEMBER 4, 2023

Managing healthcare compliance in Mississippi effectively means adapting to the state’s specific regulations, and having the right systems in place to stay on track. To successfully oversee healthcare compliance in Mississippi, organizations need to develop efficient methods for tracking regulatory updates.

Compliance 52

Compliance Telemedicine Licensing Public Health 52

MedTrainer

DECEMBER 4, 2023

Healthcare compliance in North Dakota differs in several ways from other states, primarily influenced by the state’s rural character and unique healthcare priorities. Additionally, the state’s approach to Medicaid expansion involves unique waivers, impacting eligibility criteria and cost-sharing provisions.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 29, 2023

The landscape of healthcare compliance in Tennessee is marked by distinct rules and regulations that must be adhered to by organizations across the state. This article serves as a comprehensive primer, highlighting the key elements of healthcare compliance that are specific to Tennessee.

Compliance 52

Compliance Licensing HIPAA Medicaid 52

YouCompli

SEPTEMBER 18, 2024

When conducting their periodic risk assessments, most compliance professionals use the OIG’s Work Plan or recent DOJ enforcement actions to help determine how best to deploy time and resources on auditing and monitoring efforts. You can use this information to create your own checklist for compliance audits or proactive monitoring.

Compliance 52

Compliance Medicare Medicare Medicaid 52

MedTrainer

APRIL 22, 2024

Several federal agencies highly recommend having a healthcare compliance committee — the key is to make the committee helpful, not just a regulatory checkbox. Compliance committees vary based on the size of the organization, the care setting, and the committee’s charter. What is a Healthcare Compliance Committee?

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Compliance Compliance Officers Governance Medicaid 52

MedTrainer

SEPTEMBER 8, 2023

Maintaining compliance with healthcare regulations and standards isn’t just a legal requirement; it’s a crucial element in upholding patient safety, data security, and the overall integrity of healthcare practices. Hear more on compliance essentials from a panel of expert healthcare surveyors. Why Is Healthcare Compliance Important?

Compliance 52

Compliance HIPAA Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

Effective management of healthcare compliance in West Virginia requires consistent adherence to both federal and state agency standards. To steer clear of legal or financial repercussions as a result of non-compliance, it’s crucial for organizations in West Virginia to establish robust compliance programs.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

Ensuring healthcare compliance in New Hampshire involves maintaining both federal and state guidelines, while providing quality patient care. New Hampshire healthcare organizations must develop dynamic compliance programs to keep up with evolving regulations.

Compliance 52

Compliance Licensing Public Health Medicaid 52

MedTrainer

NOVEMBER 14, 2023

Healthcare compliance regulations can vary significantly from one state to another, so managing healthcare compliance in Virginia may be different compared to other states. Regulations Unique to Virginia To meet the standards of healthcare compliance in Virginia, there are a few additional regulations.

Compliance 52

Compliance Licensing Governance Hospitals 52

MedTrainer

OCTOBER 29, 2023

California has the most rules of any state, so it’s no surprise that there is additional complexity when it comes to managing healthcare compliance in California. To effectively manage compliance, healthcare organizations must establish a robust system for monitoring and interpreting these changes and swiftly implement necessary adjustments.

Compliance 52

Compliance COVID-19 HIPAA Governance 52

AIHC

AUGUST 30, 2023

This article is educational only, and does not provide consulting or legal advice. What compliance issues need to be considered when drafting a marketing strategy? Let’s take a closer look at potential compliance risks. For example, if you’re an Internist, what better way to promote articles on diabetes.

Compliance 52

Compliance Fraud Medicare Medicare 52

Healthcare IT Today

AUGUST 22, 2024

The following is a guest article by Adam Rademacher, Director of Operations at AMN Healthcare Language Services AI’s transformative impact spans across industries– including healthcare. Or “Do you have Medicare/Medicaid?”

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Medicaid Medicaid HIPAA Medicare 124

MedTrainer

NOVEMBER 5, 2023

Colorado, like other states in the United States, has its own set of regulations and requirements that make managing healthcare compliance in Colorado tricky. To effectively manage compliance, healthcare organizations must establish a robust system for monitoring and interpreting these changes and swiftly implement necessary adjustments.

Compliance 52

Compliance Licensing Informed Consent Public Health 52

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.

Compliance 52

Compliance Medicare Medicare Fraud 52

MedTrainer

NOVEMBER 20, 2023

Managing healthcare compliance in Texas is nuanced and challenging. For successful compliance management in Texas, healthcare organizations need to develop a strong system for tracking and interpreting regulatory changes, and promptly adapt to these modifications.

Compliance 52

Compliance Licensing Public Health Governance 52

YouCompli

DECEMBER 19, 2023

Last month, the Office of Inspector General (OIG) published a new, user-friendly, 91-page General Compliance Program Guidance (GCPG). Exclusions (page 26) : OIG recommends that any entity participating in the federal Medicaid program should check the state Medicaid program exclusion list for each applicable state.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

Medisys Compliance

MARCH 5, 2024

This article explores into the details of cardiology billing, offering insights into payer audits and reimbursement challenges in cardiology billing. Compliance Risks: Cardiologists must stay abreast of evolving regulatory requirements and compliance standards to avoid penalties or audits related to fraudulent billing practices.

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Medical Billing Outsourcing Medical Billing Compliance Governance 105