American Medical Compliance

FEBRUARY 9, 2024

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. Compliance officers take on a more complex task such as the creation of medical compliance plans for their company’s long-term success.

Compliance Officers 102

Compliance Officers Compliance Patient Advocacy Regulatory Compliance 102

Healthcare Blog

JANUARY 19, 2025

Compliance with Medicare Swing Bed Rules is non-negotiable for CAHs operating these programs. Prevent fraud and abuse of Medicare funds. As CMS regulations evolve, staying ahead of compliance requirements will be crucial. CMS regulations aim to: Ensure consistent, high-quality care across facilities. Contact us today.

Medicare 52

Medicare Medicare Compliance Nurses 52

Verisys

APRIL 3, 2025

As a centralized hub of critical practitioner data, the NPDB serves as a powerful ally in provider credentialing , helping hospitals, medical boards, and institutions verify backgrounds, track malpractice claims, and ensure regulatory compliance. What Is the National Practitioner Data Bank (NPDB)?

Malpractice 52

Malpractice Licensing Compliance Hospitals 52

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. Gandle, for her contribution to this blog post. The GCPG further explains how to implement these elements.

Compliance 52

Compliance Due Diligence Fraud Governance 52

MedTrainer

FEBRUARY 1, 2024

These programs help to promote lawful and ethical conduct within healthcare organizations and minimize the risk of legal violations, such as fraud, abuse, and other unethical behaviors. Why do healthcare facilities use corporate compliance programs? What is Corporate Compliance in Healthcare?

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 52

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. Definition of compliance culture in healthcare.

Compliance 52

Compliance Compliance Officers Fraud Regulatory Compliance 52

Compliancy Group

JANUARY 17, 2024

The OIG Work Plan, sometimes referred to as “the Work Plan” or “the Plan,” is an essential tool in securing and maintaining healthcare regulatory compliance for patient safety, privacy, and quality care. The OIG Compliance Work Plan identifies significant risks and areas that require attention within the healthcare system.

US Department of Health and Human Services 52

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

MedTrainer

JULY 29, 2024

These tools make it easier for healthcare organizations to maintain a culture of compliance, adapt to evolving industry standards, and ensure that all staff members are consistently informed and compliant. Corporate Compliance vs. Regulatory Compliance Corporate compliance and regulatory compliance are not the same thing.

Compliance 52

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

Verisys

NOVEMBER 30, 2022

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. Excluded from one means excluded from all, and the fines for non-compliance will likely be in the hundreds of thousands. How many data sources is your organization monitoring?

Medicare 52

Medicare Medicare Regulatory Compliance Medicaid 52

MedTrainer

JANUARY 31, 2024

Certified Professional Compliance Officer (CPCO): The CPCO certification is offered by the American Academy of Professional Coders and is tailored to professionals who manage and lead compliance programs. Certified Medical Compliance Officer (CMCO): The CMCO certification is offered by the Practice Management Institute.

Compliance 52

Compliance Compliance Officers Fraud HIPAA 52

MedTrainer

JANUARY 26, 2024

Ways Compliance Can Decrease Revenue Fines and Penalties: Compliance with federal, state, and local regulations is essential to avoid fines, penalties, and legal liabilities. Denied Claims: Failure to comply with coding and billing regulations can lead to denied claims, delayed reimbursement, or even accusations of fraud.

Compliance 52

Compliance Fraud Regulatory Compliance Health Insurance 52

Verisys

FEBRUARY 6, 2025

By thoroughly evaluating a nurse’s credentials, healthcare organizations can: Minimize the risk of medical errors Ensure compliance with regulatory requirements Maintain a high level of patient trust Credentialing also serves as a mechanism for ongoing professional development.

Nurses 52

Nurses US Department of Health and Human Services Licensing Regulatory Compliance 52

Verisys

JANUARY 8, 2024

A healthcare compliance audit is a thorough review and examination of an organization’s adherence to regulatory guidelines. This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

Verisys

FEBRUARY 6, 2025

Why Provider Data Management Is Essential in Healthcare Provider data management in healthcare is crucial for ensuring patient safety, regulatory compliance, and operational efficiency. Ensuring Compliance and Reducing Risk Proper data management is your shield against regulatory headaches.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Malpractice 52

MedTrainer

AUGUST 30, 2023

Some key compliance elements for managed care organizations include: Legal and Regulatory Compliance. These include laws related to insurance, healthcare privacy (HIPAA), billing practices, and fraud and abuse prevention. Quality of Care Standards.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Verisys

FEBRUARY 14, 2024

Mitigating Provider Risk: Verisys’ solutions, such as FACIS® (Fraud Abuse Control Information System) , provide in-depth screening and continuous monitoring of healthcare professionals against the largest dataset of disciplinary actions and exclusions. How does Verisys help with risk management in healthcare?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

MedTrainer

JULY 25, 2024

Because enterprise healthcare organizations may employ hundreds or thousands of people, having a HIPAA compliance checklist helps to effectively manage the complexities of protecting patient information, reducing the risk of violations, and maintaining a culture of compliance throughout the organization. What Is HIPAA?

HIPAA 52

HIPAA Compliance Health Insurance Fraud 52

Verisys

DECEMBER 29, 2024

Healthcare organizations and insurance companies rely on credentialing to ensure patient safety, regulatory compliance, and minimize liability risks. This includes verifying education, residency, employment history, malpractice insurance, hospital privileges, and board certifications.

Malpractice 52

Malpractice Licensing Regulatory Compliance Hospitals 52

Verisys

FEBRUARY 7, 2024

Preventing fraud by verifying the credentials of scientists, speakers, sales representatives, and research and clinical trial participants. Verisys streamlines the credentialing process with faster turnaround times, and the most accurate and quality data in the industry, ensuring that all providers meet compliance standards​​.

Licensing 52

Licensing Compliance Compliance Framework Fraud 52

MedTrainer

NOVEMBER 2, 2023

Most compliance officers possess a bachelor’s degree, often in healthcare administration, law, or a related field. Additionally, hands-on experience in healthcare or regulatory compliance provides a foundation for this role.

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

MedTrainer

SEPTEMBER 8, 2023

Certified Professional Compliance Officer (CPCO): The CPCO certification is offered by the American Academy of Professional Coders and is tailored to professionals who manage and lead compliance programs. Certified Medical Compliance Officer (CMCO): The CMCO certification is offered by the Practice Management Institute.

Compliance 52

Compliance Compliance Officers HIPAA Regulatory Compliance 52

Physician Credentialing Company

JULY 15, 2024

This process reduces the risk of fraud and ensures accuracy. Regulatory Compliance: Helps healthcare organizations comply with industry standards and regulations, avoiding legal penalties and enhancing credibility. It also involves checking for any disciplinary actions or malpractice history.

Malpractice 52

Malpractice Compliance Licensing Medical Billing 52

MedTrainer

AUGUST 2, 2023

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Hall Render

NOVEMBER 25, 2024

Quality of Care and Quality of Life OIG identified that beyond the Requirements of Participation for Long Term Care Facilities in 42 CFR 483 , the failure to provide quality care and promote quality of life poses a risk of fraud and abuse for nursing facilities. Hall Render blog posts and articles are intended for informational purposes only.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

MedTrainer

JULY 31, 2024

A well-executed GRC strategy using healthcare compliance management software enables organizations to improve patient safety outcomes by proactively identifying and mitigating potential risks.

Governance 52

Governance Compliance HIPAA Regulatory Compliance 52

MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

MedTrainer

JANUARY 16, 2025

MedTrainer Live: Upcoming NCQA Credentialing Changes Watch Now DEA Registrant Validation: In 2024, the DEA changed registrant validation to avoid fraud. This will include expiration date tracking, shorter verification times, and expanded exclusions to include SAM.gov and are all required every 30 days.

Compliance 52

Compliance Regulatory Compliance COVID-19 HIPAA 52

Drug & Device Law

DECEMBER 29, 2023

2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. This year’s Drug & Device Law Blog top ten decisions of the year reinforced preemption – the most powerful defense we can assert. If any of these are your cases, the Blog congratulates you. Monsanto Co. , 4th 1261 (11th Cir. 4th 851 (6th Cir. 4th 696 (3d.

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FDA US Department of Health and Human Services COVID-19 COVID-19 Vaccine 105

Drug & Device Law

JUNE 5, 2023

Kelley was actually decided a couple of months ago, but due to Reed Smith’s involvement in the case, we could not blog about it until the matter recently settled. Finally, Defendant argues that Georgia law permits regulatory compliance to generally rebut the high willfulness requirement for punitive damages. citation omitted).

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FDA Regulatory Compliance Compliance Fraud 59