Verisys

MARCH 6, 2025

What Is AI in Healthcare Compliance? Imagine having a tireless assistant who handles the nitty-gritty of regulatory compliance so healthcare teams can focus on what matters mostpatient care and privacy. AI in healthcare compliance taps into the power of machine learning, natural language processing, and automation.

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Verisys

MARCH 6, 2025

In the healthcare industry, compliance with regulatory standards is not merely a requirement but a cornerstone of safe, effective, and ethical patient care. When healthcare organizations fail to meet compliance standards, the consequences can be severespanning legal and financial realms. What is Non-Compliance in Healthcare?

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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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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. The OIG is making major investments to systematically detect and prosecute fraud.

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American Medical Compliance

FEBRUARY 9, 2024

Compliance officers’ responsibilities extend far beyond merely checking boxes and ticking off regulatory requirements. In fact, 61% of the compliance teams from a Thomson Reuters report also work on long-range strategies for their companies by putting regulatory and legislative changes as a top priority.

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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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Verisys

NOVEMBER 3, 2023

Healthcare Fraud Crackdown! Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: Entity Fraud Cardiac imaging company and founder to pay historic $85M settlement Full Story Genomic Health Inc. to Pay $32.5 to Pay $32.5 Secure your success by choosing Verisys.

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Healthcare Blog

NOVEMBER 9, 2023

An effective healthcare compliance program is a crucial aspect of any healthcare organization. Healthcare organizations should clearly define their expectations and the consequences for non-compliance. Healthcare organizations should clearly define their expectations and the consequences for non-compliance.

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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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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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Verisys

DECEMBER 13, 2023

Healthcare Fraud Crackdown! Each month we will give a roundup of recent healthcare fraudsters and compliance busters. The post Healthcare Fraud Crackdown: Telehealth Fraud & Improper Billing Scams | Verisys appeared first on Verisys. Secure your success by choosing Verisys.

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Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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Healthcare Compliance Blog

APRIL 29, 2022

in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. In March 2020 she pleaded guilty to one count of healthcare fraud, one count of wire fraud, and one count of theft of government funds. Provide periodic retraining to members of the compliance and ethics committee as well.

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Healthcare Compliance Blog

JANUARY 25, 2022

A Missouri woman who had previously pled guilty to Medicare and Medicaid fraud was sentenced in Federal Court to three years imprisonment and ordered to pay $7,620,779 in restitution. Discussion Points: Review your policy and procedure for preventing and reporting false claims, kickbacks, or other fraud, waste, and abuse violations.

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MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital.

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Healthcare Compliance Blog

FEBRUARY 22, 2022

Two women, one from Colorado and the other from Houston, have been sentenced in federal court for their roles a multi-million dollar Medicare Fraud Scheme. Each woman pled guilty to one count of conspiracy to commit healthcare fraud. The post Two Women Sentenced for Conspiracy to Commit Healthcare Fraud appeared first on.

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McBrayer Law Blog

SEPTEMBER 28, 2021

Posted In COVID-19 , Health Care Fraud , Healthcare Regulation , Telehealth The shift to telemedicine in the United States predates the pandemic, but COVID-19 has accelerated its widespread use.

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MedTrainer

MARCH 8, 2024

Employee compliance training is essential to any healthcare organization’s onboarding process. This blog post will explore why compliance training is vital for an industry where mistakes or non-compliance can seriously affect patients, staff, and the organization.

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MedTrainer

JANUARY 12, 2024

Healthcare compliance is serious business for regulators. In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. What is Healthcare Compliance?

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Verisys

MARCH 23, 2023

3 Healthcare Fraud and Abuse Laws Providers Should Know About In 2021, the Department of Justice reported recovering over $5.5 billion from settlements due to fraud and false claims. As a healthcare provider, being familiar with healthcare fraud and abuse laws is important. government or a government contractor.

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Verisys

JANUARY 8, 2024

OIG compliance refers to adherence to the guidelines and regulations set forth by the Office of Inspector General (OIG) of the U.S. The OIG is responsible for combating fraud, waste, and abuse in health and human services programs, including Medicare and Medicaid. The post What is OIG Compliance? appeared first on Verisys.

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MedTrainer

FEBRUARY 1, 2024

A corporate compliance program in healthcare is a comprehensive set of policies, procedures, and practices that healthcare organizations establish and maintain to ensure that they operate compliant with all applicable laws, regulations, and ethical standards. Why do healthcare facilities use corporate compliance programs?

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Healthcare Law Blog

NOVEMBER 9, 2023

In late April this year, the Office of Inspector General, Department of Health and Human Services (OIG) announced that it would make changes to its existing body of healthcare compliance program guidance (CPGs) as part of its current Modernization Initiative. [1] On November 6, 2023, OIG finally published the GCPG on its website [3].

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Provider Trust

AUGUST 6, 2024

Healthcare compliance monitoring has never been easy. So, what makes an effective compliance monitoring program? The compliance spectrum helps organizations of all sizes identify the effectiveness of their compliance monitoring based on three key factors: population, primary sources, and frequency.

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Health Law RX

JANUARY 30, 2024

By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The DOJ Announcement stresses the importance of investing in strong compliance programs for both the buyers and sellers in business transactions.

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Provider Trust

MARCH 21, 2023

Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs. According to Grimm, the risk of alleged fraud and abuse in Medicare Advantage by plans, vendors, and providers is not to be ignored.

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Medisys Compliance

NOVEMBER 6, 2023

Introduction Orthopedic billing compliance is essential for healthcare providers to avoid costly audits and penalties. By following a comprehensive orthopedic billing compliance checklist, providers can ensure that their claims are accurate, complete, and supported by proper documentation.

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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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MedTrainer

FEBRUARY 24, 2025

Healthcare compliance audits can be highly stressful for organizations. A structured healthcare compliance audit preparation checklist simplifies the process, allowing you to meet regulatory expectations and avoid common compliance pitfalls. This blog will walk you through essential steps to prepare for these audits effectively.

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MedTrainer

FEBRUARY 12, 2024

How are healthcare organizations ensuring compliance and minimizing exposure risks to false claims? In this blog, we’ll share how healthcare organizations are managing compliance around false claims and safeguarding both the integrity of healthcare services and the welfare of patients.

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MedTrainer

JANUARY 30, 2024

Healthcare compliance is a critical part of any organization’s business model. The professionals who manage compliance are the front lines of preventing medical errors, deterring fraud, and staying in good standing with federal payers like the Centers for Medicare and Medicaid Services (CMS).

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MedTrainer

JANUARY 31, 2024

Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program? It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. What is Healthcare Compliance?

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MedTrainer

JUNE 11, 2024

Included in this blog post are the results of an audit on Florida requirements. What Is Required for Florida Compliance Training? Healthcare compliance training is not a one-size-fits-all solution. Meeting Multiple Standards: Compliance training courses that meet multiple standards are a win-win for organizations and employees.

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MedTrainer

OCTOBER 23, 2023

In today’s intricate healthcare landscape, compliance can mean a lot of different things, which might leave you wondering, “What is healthcare compliance?” At its core, healthcare compliance is adherence to the vast array of regulatory and procedural standards that protect patients and ensure the highest standard of care.

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MedTrainer

JANUARY 30, 2024

What types of healthcare facilities are required by the government to have a compliance program? In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them.

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MedTrainer

JULY 31, 2024

Meeting Tennessee training requirements for compliance is critical to maintain this level of excellence. Included in this blog post are the results of an audit on Tennessee requirements. What Is Required for Tennessee Compliance Training? Healthcare compliance training is not a one-size-fits-all solution.

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MedTrainer

JUNE 11, 2024

Included in this blog post are the results of an audit on Texas requirements. What Is Required for Texas Compliance Training? Healthcare compliance training is not a one-size-fits-all solution. Meeting Multiple Standards: Compliance training courses that meet multiple standards are a win-win for organizations and employees.

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