Compliancy Group

OCTOBER 4, 2024

Despite your best efforts in meeting healthcare compliance requirements, errors may still occur. Maintaining the security and integrity of sensitive information and preventing waste, fraud, and abuse is essential to quality healthcare and promoting workplace safety.

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MedTrainer

NOVEMBER 2, 2023

This critical responsibility rests on the shoulders of the healthcare compliance officer. Read on if you’ve ever wondered about the unsung heroes as we answer the question: What does a compliance officer do in healthcare? What Is the Primary Role of a Compliance Officer in Healthcare?

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Health Law RX

NOVEMBER 22, 2023

The GCPG has been anticipated since the OIG announced on April 25, 2023, that it planned to modernize the accessibility and usability of its publicly available resources, including the OIG’s Compliance Program Guidance (CPG) documents. Ensure individuals are not deterred from reporting compliance concerns (e.g.,

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HIPAA Journal

MARCH 30, 2023

While the seven elements of a compliance program apply to all industries, they originated in the healthcare industry in the 1990s. This was in response to the growing level of healthcare fraud and abuse and an alleged “compliance disconnect” at the executive level in many hospitals and health systems.

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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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MedTrainer

JUNE 28, 2023

In healthcare especially, fraud is something responsible providers need to be on the lookout for. It’s why many organizations choose to work with a Certified Fraud Examiner as part of their ongoing efforts to remain responsible and compliant with financial best practices. What is a Certified Fraud Examiner?

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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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American Medical Compliance

FEBRUARY 15, 2023

The Dental Healthcare Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. To become certified, please visit us at: American Medical Compliance (AMC).

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Healthicity

SEPTEMBER 26, 2024

CJ Wolf sits down with Rebecca Busch , a healthcare compliance expert with over four decades of experience. From her early days as a trauma nurse to her current role as a sought-after expert witness, Rebecca has seen it all in the ever-evolving world of healthcare compliance and fraud.

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HealthStream

AUGUST 26, 2019

Compliance officers must work to prevent criminal healthcare fraud cases, especially given the expansion of DOJ focus areas for investigating possible fraudulent action.

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Provider Trust

MARCH 13, 2023

Twenty-five people were charged with criminal wire fraud and wire fraud conspiracy for their involvement in the scheme, and these people could face up to 20 years in jail. Donna Thiel, Chief Compliance Officer at ProviderTrust, said, “It’s an opportunity to promote partnership between HR and compliance.

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AIHC

JUNE 14, 2024

Financial exploitation refers to 2 types of financial crimes committed against older adults: Financial abuse (committed by someone you know) Financial fraud (committed by a stranger) Both result in serious financial, physical, and emotional harm to older adults. Call the Elder Fraud Hotline at 1-833-372-8311 (Monday-Friday, 10:00 a.m.-6:00

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Health Care Performance

JULY 20, 2022

Compliance lesson: Enforcement agencies are actively using data analytics to identify, investigate and prosecute providers with unusual billing activity – and so should you. Mole billing fraud scheme totals $4.1 It is impossible to draft policies and train staff on for every possible compliance risk scenario. L earn more.

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American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Fraud schemes range from solo ventures to widespread activities of an institution or group.

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MedTrainer

JANUARY 10, 2024

Review Recent Compliance Changes There is a major shift in compliance priorities toward addressing health inequities and improving access to quality healthcare services. The OIG is making major investments to systematically detect and prosecute fraud. We all should be a LOT more prepared!

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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. But what exactly is considered fraud, waste, and abuse? These complaints can trigger an audit. Data Analysis and Trends.

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Compliancy Group

OCTOBER 28, 2024

Established in 1976, the Office of Inspector General (OIG) has led the U.S. Health and Human Services (HHS) Department’s efforts to eliminate fraud, waste, and abuse. Its compliance program guidance (CPG) has improved the efficiency and effectiveness of Medicare and many other federal programs.

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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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YouCompli

MAY 11, 2022

The doctor will be sentenced in July for multiple counts of healthcare fraud. Compliance officers should watch for: Follow the money. If a practice is billing millions of dollars for allergies services, that code or set of codes is likely to stand out as an outlier to compliance programs monitoring all their billing data.

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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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Compliancy Group

MARCH 21, 2024

Office of Inspector General (OIG) of the Department of Health and Human Services (DHHS) oversees regulations covering federal programs offering benefits to healthcare organizations. All these tasks can seem daunting to even the most organized compliance officers. For example, how do they make the training engaging and memorable?

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AIHC

SEPTEMBER 25, 2024

Reviewing the Office of Inspector General's (OIG) enforcement actions is important for compliance officers because it can help them understand the OIG's focus and priorities, and how to comply with federal health care laws and regulations. Register for online training to certify in various areas of compliance.

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Compliancy Group

MARCH 22, 2024

As a compliance officer or critical decision-maker, you can help your healthcare organization avoid exclusion from this valuable program by creating a comprehensive compliance program and using software to streamline your compliance processes. Over 65 million people in the U.S.

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Compliancy Group

NOVEMBER 6, 2024

Importance of Workforce Compliance Compliance with workforce requirements in healthcare involves ensuring the organization and its members comprehend and adhere to laws governing patient safety and privacy, maintaining secure working conditions, and preventing fraud, waste, and abuse.

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Compliancy Group

AUGUST 9, 2024

Importance of Compliance Documents to Your Healthcare Organization Besides enabling various compliance activities, readily available compliance documents can make a significant difference in maintaining your entity’s reputation. Examples include confidentiality agreements, business associate agreements , copyrights, and patents.

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Healthcare Compliance Blog

FEBRUARY 15, 2022

billion in settlements and judgments have been recovered by the Department of Justice Department (DOJ) related to civil cases involving fraud and false claims in fiscal year 2021. The government paid $237 million in fiscal year 2021 to whistleblowers who exposed fraud and false claims. More than $5.6

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Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. Such an ongoing auditing system is crucial to a healthcare organization’s compliance program.

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Healthcare Law Blog

NOVEMBER 9, 2023

Thereafter, OIG said it planned to update existing industry-specific compliance program guidance (ICPG), which would include tailoring each to address fraud and abuse risk areas specific to a particular industry and describing the compliance measures that industry could take to reduce these risks [2].

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AIHC

MAY 31, 2022

Health care insurance fraud is a pressing problem, causing substantial and increasing costs in medical insurance programs. To combat fraud and abuse, all levels within a medical practice, hospital or health care organization must know how to protect the organization from engaging in abusive practices and violations of civil or criminal laws.

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Compliancy Group

FEBRUARY 26, 2024

A comprehensive hospital compliance work plan is pivotal for achieving these objectives. Hospital compliance officers, c-suite executives, and other decision-makers must constantly stay abreast of the latest developments in healthcare compliance.

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Compliancy Group

SEPTEMBER 16, 2024

In November, updates for 2024 appeared in the OIG General Compliance Program Guidance, including recommendations for Medicare, nursing facilities, and other industry-specific entities. Compliance officers have access to more information about their responsibilities and roles.

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Healthcare Blog

NOVEMBER 9, 2023

A well-implemented compliance program enhances patient care by emphasizing ethical procedures, confidentiality, and data protection. It assists in identifying and addressing any concerns early on, lowering the likelihood of fraud, waste, and abuse. This inclusion helps to ensure varied perspectives and thorough analysis.

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Compliancy Group

OCTOBER 16, 2024

There’s a significant connection between healthcare compliance and risk management. Compliance officers must thoroughly understand both concepts to protect their organizations and the patients they serve. Risk management refers to identifying, avoiding, and mitigating the factors contributing to healthcare non-compliance.

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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.

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Healthcare IT Today

DECEMBER 20, 2022

Since the requirement for HIPAA privacy training took effect 20 years ago, many organizations now treat it just as a checklist item – often part of a series of once-a-year ‘get-out-of-the-way’ training videos and quizzes that include OSHA safety, fraud and abuse, and sexual harassment.

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American Medical Compliance

OCTOBER 25, 2024

A powerful way to ensure this is through regular compliance audits. Audits serve as a critical defense against fraud and inefficiency while fostering trust in your practice. This is to confirm that staff are properly trained in compliance protocols. You might also focus on employee training and education.

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YouCompli

SEPTEMBER 13, 2023

Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Given the severity of penalties associated with FWA, compliance professionals’ knowledge and skills will be crucial to ensuring that their organizations avoid penalties and provide compliant patient care.

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