Healthcare Compliance Blog

MAY 19, 2022

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. Following an internal review and audit, the hospital discovered irregularities regarding its billing of certain services, and proactively contacted the United States to self-disclose the issues.?The to resolve the claims.

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Jane Sarashon

MARCH 12, 2024

That’s TMI for me to write about in the Health Populi blog, but this story has a current-events twist: the pharmacist could not electronically link with my insurance company to transact my payment. The Department of Health and Human Services finally weighed in on the situation on March 5th.

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Healthcare Compliance Blog

APRIL 26, 2022

The Office of Inspector General (OIG) for the US Department of Health and Human Services (HHS) has made educational resources available for healthcare providers to comply with federal healthcare laws and regulations. Department of Health and Human Services (hhs.gov).

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Medval Compliance Blog

MARCH 10, 2022

by Frank Fairchok, Vice President of Medicare Reporting Services. Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. 0938-AT85 – Medicare Secondary Payer and Future Medicals (CMS-6047).

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Healthcare Law Blog

MARCH 17, 2022

On Thursday, March 16, the Office of the Inspector General for the Department of Health and Human Services (“OIG”) issued OIG Advisory Opinion (“AO”) No. 22-05 , relating to subsidization of certain Medicare cost-sharing obligations in the context of a clinical trial involving medical devices (the “Proposed Arrangement”).

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MedTrainer

FEBRUARY 29, 2024

In this blog, we’ll describe near-miss events and how incident reporting software helps healthcare organizations better understand causes and ways to prevent future problems. Near-Miss Events are Common A study by the National Institutes of Health (NIH) found that near-miss events occurred in nearly 23% of 5,582 emergency department cases.

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Healthcare Compliance Blog

MAY 10, 2022

The provider had created a business to provide home and community-based services to Medicaid recipients. The provider had created a business to provide home and community-based services to Medicaid recipients. An ineligible Medicaid provider was arrested in Florida for defrauding Medicaid of more than $68,000.

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Healthcare Law Blog

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

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Healthcare Law Today

FEBRUARY 6, 2023

As of 2019 almost 95% of such persons had Medicare coverage and about half of those also had some sort of supplemental health insurance coverage. The United States is aging, and becoming more obese, and the need for cardiologists will increase as a result. Moreover, 40% of Americans are considered medically obese.

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MedTrainer

JULY 29, 2024

Corporate compliance training software is vital to tailoring programs to staff, departments, and locations. Corporate compliance training software is vital to tailoring programs to staff, departments, and locations. Department of Health & Human Services ( HHS ). monitorship or reporting obligations).”

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YouCompli

DECEMBER 7, 2022

Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.

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YouCompli

FEBRUARY 22, 2023

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). The inflated charges resulted in inappropriate outlier payments from Medicare.

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YouCompli

NOVEMBER 30, 2022

How to use the SBAR Framework. The same tool nurses use to communicate about health emergencies – can help you secure investment in your compliance department. . While its primary use is in clinical cases, healthcare professionals across the organization are finding it useful for communicating with clinical leaders.

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YouCompli

SEPTEMBER 13, 2023

Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic. In addition, CMS education and outreach focuses on preventing, detecting, and reporting Medicare fraud and abuse.

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Compliancy Group

JANUARY 17, 2024

In this blog post, we look closely at the intricacies of the Plan, exploring how it shapes the healthcare compliance landscape. Department of Health and Human Services (HHS), is tasked with combating fraud, waste, and abuse in health programs, ensuring efficiency, and promoting the integrity of HHS programs, including Medicare and Medicaid.

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Compliancy Group

MARCH 19, 2024

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number).

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Provider Trust

JANUARY 26, 2022

Luckily for all us, there’s a spectrum–and it was created with visibility and safety in mind. Department of Justice (DOJ), the U.S. Task forces, such as the Medicare Fraud Strike Force , work together to help uphold the FCA. How the OIG Finds & Prosecutes Healthcare Fraud.

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Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

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MedTrainer

OCTOBER 16, 2023

Dive with us as we explore the complexities and necessities of compliance in the healthcare sector. Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a pivotal regulation that focuses on the protection of patient health information, enforced by the U.S. Department of Health and Human Services (HHS).

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YouCompli

NOVEMBER 16, 2022

Sharon Parsley, JD, MBA, CHC, CHRC’s writes a monthly series on compliance officer effectiveness for the YouCompli blog. Most of us have had the experience of preparing for an important conversation or interaction, only to leave it feeling defeated, misunderstood and not even really heard. Discriminative Listening: .

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Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. See Vista Health Plan, Inc. United States Dep’t of Health & Hum. The Risk-Adjustment Program.

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YouCompli

SEPTEMBER 6, 2023

I was responsible for allocating financial, human, and physical resources to accomplish certain tasks.   By doing so, you and your project team will be excellent stewards of the human and physical resources needed to complete the project. Was “project manager” in your current or previous job descriptions? Agree to due dates.

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YouCompli

NOVEMBER 18, 2023

Most of us have had the experience of preparing for an important conversation or interaction, only to leave it feeling defeated, misunderstood, and not even really heard. Discriminative Listening According to betterup.com , discriminative listening is a skill all humans are born with. Soldier on with your scripted remarks?

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MedTrainer

FEBRUARY 13, 2022

The Office of Inspector General for the Department of Health and Human Services is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.

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MedTrainer

AUGUST 8, 2022

The Office of Inspector General for the Department of Health and Human Services is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.

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Healthcare Law Blog

JANUARY 14, 2022

And since the conference was virtual, what better topic to start us off today than a consideration of the new Virtual-First trend that surfaced in 2021. We’ll follow that with a dive onto the couch to consider the conference’s mental health offerings and where the behavioral health sector is heading. During Day 4 of the J.P.

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Healthcare Law Blog

JANUARY 12, 2022

The phrase “whole person health” kept echoing through the virtual hallways during the second day of the 40 th Annual J.P. Cordani made the same point we heard yesterday – technology and virtual care present tremendous opportunities to address chronic condition management, mental health and physical health needs.

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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.” The result?

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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.” The result?

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Healthcare Law Blog

DECEMBER 7, 2022

On December 5, 2022, the Department of Health and Human Services (“ HHS ”), Office of Inspector General (“ OIG ”), released their Semiannual Report to Congress for the period beginning on April 1, 2022, and ending on September 30, 2022 (the “ Semiannual Report ”). [1]. million $1.19 billion Questioned Costs $1.17

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Bill of Health

SEPTEMBER 19, 2024

This post launches a new Digital Symposium: Supreme Court Preview: Key Health Law Issues for the 2024 Term , guest edited by Cary Franklin , Professor of Law, McDonald/Wright Chair of Law, and Faculty Director of the Center on Reproductive Health, Law, and Policy and the Williams Institute at UCLA Law; and Lindsay F.

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Hall Render

JUNE 21, 2024

NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. The deal fell through, but that won’t solve Bartlett’s budget issues. Kenai Peninsula Borough Assembly considers $38.5M Kenai Peninsula Borough Assembly considers $38.5M

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Hall Render

APRIL 14, 2023

NATIONAL 94% of Organizations Experienced a Cyberattack in 2022 AHA blog: Strengthening crisis management in rural health care Biden signs bill ending Covid-19 national emergency Cancer drug shortages are creating dire circumstances for some patients CMS Releases FY24 IPPS Proposed Rule, Seeks to Boost Rates by 2.8%

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Drug & Device Law

DECEMBER 29, 2023

Executive Health Resources, Inc. , Executive Health Resources, Inc. , 2023) (rejecting any express anti-preemption presumption in Medicare case) ( here ); Baker v. United States Department of Health and Human Services , 58 F.4th In 2023, these include United States ex rel. Polansky v. 3d 239 (Cal.

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