Compliancy Group

FEBRUARY 22, 2024

The healthcare industry faces an ever-increasing number of essential regulations, making developing a reliable compliance strategy crucial. Have you explored the best path to ensure peak healthcare compliance officer training? It’s a role that transcends mere oversight.

Compliance Officers 52

Compliance Officers Compliance Fraud Regulations Compliance 52

Verisys

FEBRUARY 23, 2022

As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. Accordingly, maintaining compliance has become a key focus for healthcare facilities. HCO Qualifications. Reimbursement.

Compliance Officers 52

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

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.

Compliance 109

Compliance Compliance Officers Fraud HIPAA 109

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?

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

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.

Compliance Officers 59

Compliance Officers Compliance Regulatory Compliance Fraud 59

HIPAA Journal

JANUARY 30, 2023

The National HIPAA Summit is the leading forum on healthcare EDI, privacy, breach notification, confidentiality, data security, and HIPAA compliance, and the deadline for registration for the Virtual 40th National HIPAA Summit is fast approaching.

US Department of Health and Human Services 81

US Department of Health and Human Services HIPAA Compliance Medicaid 81

Healthcare IT Today

MARCH 27, 2025

Without strict governance, AI tools could inadvertently violate HIPAA and other healthcare privacy laws, placing patient confidentiality at riskmissteps that are not easily forgiven. Data privacy remains a primary concern, as AI systems rely on vast datasets that often include sensitive patient information.

Governance 60

Governance Compliance HIPAA Regulatory Compliance 60

Compliancy Group

MARCH 12, 2025

A healthcare organization that does not follow proper methods of obtaining reimbursement from federal payor programs such as Medicare may run afoul of federal fraud, waste, and abuse laws. Some denials result from noncompliance with federal fraud, waste, and abuse laws. Such noncompliance can result in non compliance fines.

Fraud 52

Fraud Compliance Medicare Medicare 52

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. The Seven Elements of an Effective Compliance Program. OIG Resources and Processes.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Verisys

MARCH 6, 2025

Joint Commission Ensuring healthcare providers maintain quality and safety by streamlining compliance with national standards and accreditation processes. Health Insurance Portability and Accountability Act (HIPAA) Ensuring patient privacy by constantly monitoring data handling practices. Complete Healthcare Compliance Manual 2024.

Compliance 52

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

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?

Fraud 52

Fraud Compliance Governance Compliance Officers 52

MedTrainer

JULY 25, 2024

Adhering to the Health Insurance Portability and Accountability Act (HIPAA) standards is crucial to uphold compliance and regulatory requirements for any health organization. What Is HIPAA? HIPAA, enacted in 1996, originally aimed to improve health insurance portability and reduce healthcare fraud.

HIPAA 52

HIPAA Compliance Health Insurance Fraud 52

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.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

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.

Compliance 72

Compliance Compliance Officers Regulations Compliance HIPAA 72

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. Government agencies expect your organization to stay informed.

Fraud 52

Fraud Compliance Compliance Officers Licensing 52

MedTrainer

AUGUST 8, 2024

The training covers the seven core compliance program requirements mandated by CMS, including written policies and procedures, designation of a compliance officer, effective training and education, and procedures for prompt response to compliance issues.

Medicare 93

Medicare Medicare Compliance Medicaid 93

Compliancy Group

JUNE 3, 2024

What To Know When Navigating HIPAA Incidents Health Insurance Portability and Accountability Act (HIPAA) regulations already require healthcare-based businesses to have a response plan while operational. For many compliance officers, though, it’s not only about the documentation tracking — it’s about the overall savings.

Compliance 59

Compliance Compliance Officers HIPAA Fraud 59

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?

Compliance 52

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

Healthcare Blog

NOVEMBER 9, 2023

Such a program assures compliance with applicable laws, regulations, and industry standards, reducing the risk of legal and financial ramifications. A strong compliance program assists organizations in navigating this complicated landscape while avoiding potential breaches and penalties.

Compliance 98

Compliance Compliance Officers ACA Patient Satisfaction 98

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.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

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.

Compliance 52

Compliance Compliance Officers Fraud Regulatory Compliance 52

MedTrainer

JANUARY 31, 2024

This certification, offered by the CCB, showcases a deep understanding of compliance, ethics, and risk management principles, making it highly relevant for healthcare compliance roles. Certified HIPAA Professional (CHP): Several entities, such as ECFC, offer versions of a CHP certification.

Compliance 52

Compliance Compliance Officers Fraud HIPAA 52

Compliancy Group

AUGUST 30, 2024

We suggest incorporating them into an annual compliance checklist for companies across the healthcare sector. HIPAA The Health Insurance Portability and Accountability Act (HIPAA) of 1996 governs how healthcare organizations handle protected health information (PHI). Under the direction of the U.S.

Compliance 52

Compliance Fraud Compliance Officers HIPAA 52

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).

Compliance 52

Compliance Compliance Officers Fraud Medicaid 52

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. The updated OIG General Compliance Program Guidance also focuses more on improving the quality of patient care and identifying the factors that undermine care.

Compliance 52

Compliance Compliance Officers Fraud Electronic Medical Records 52

Compliancy Group

AUGUST 31, 2023

Healthcare compliance laws play a vital role in safeguarding patients’ rights, preventing fraud and abuse, and maintaining the integrity of healthcare systems. Let’s delve into the importance of healthcare compliance laws and regulations, their impact on providers and organizations, and the guidelines governing their implementation.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52

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].

Compliance 52

Compliance Compliance Officers Fraud Medicare 52

Compliancy Group

JULY 12, 2023

Organizations must establish and implement an effective compliance program encompassing seven key elements to achieve this. Let us delve into these essential components and understand how they contribute to upholding healthcare compliance requirements. Designating a compliance officer and compliance committee.

Compliance 52

Compliance Compliance Officers Fraud HIPAA 52

Compliancy Group

MARCH 8, 2024

Many physical therapy practices are under the false assumption that they don’t need to comply with regulatory standards such as HIPAA, often discussing patient care in front of other patients. However, failing to follow healthcare compliance standards can harm your patients and your practice.

Compliance 52

Compliance Compliance Officers Fraud HIPAA 52

MedTrainer

JANUARY 26, 2024

Compliance Officers: Healthcare compliance officers , responsible for overseeing and enforcing compliance within healthcare organizations, often hold healthcare regulatory compliance certificates. These certificates validate their expertise in monitoring and ensuring compliance within their institutions.

Regulatory Compliance 52

Regulatory Compliance Compliance Compliance Officers HIPAA 52

MedTrainer

AUGUST 31, 2023

Compliance is crucial in healthcare to safeguard patients’ well-being, maintain trust in the industry, and avoid legal and financial repercussions. It also helps prevent fraud, abuse, and errors, ensuring the delivery of high-quality care and ethical decision-making. What Is HIPAA and How Does It Impact Healthcare Compliance?

Compliance 52

Compliance Compliance Officers HIPAA Fraud 52

MedTrainer

NOVEMBER 14, 2023

Legal and Regulatory Risks: Non-compliance with laws and regulations like HIPAA can lead to fines, penalties, and legal expenses. Financial Risks: They encompass losses from billing errors, fraud, and abuse claims, or failed investments related to healthcare provisions.

Compliance 52

Compliance Compliance Officers Fraud Malpractice 52

MedTrainer

SEPTEMBER 8, 2023

This certification showcases a deep understanding of compliance, ethics, and risk management principles, making it highly relevant for healthcare compliance roles. Certified HIPAA Professional (CHP): Several entities, such as ECFC, offer versions of a CHP certification.

Compliance 52

Compliance Compliance Officers HIPAA Regulatory Compliance 52

Medisys Compliance

JANUARY 30, 2023

Let us discuss the top compliance issues in the medical billing industry, shall we? HIPAA: The Health Insurance Portability and Accountability Act( HIPAA) is a federal law that establishes the national standards for protecting the privacy and security of individuals’ personal health information ( PHI).

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

MedTrainer

NOVEMBER 14, 2023

Certified HIPAA Professional (CHP) : Offered by organizations such as ECFC, the CHP designation is tailored for those responsible for aligning healthcare operations with the Health Insurance Portability and Accountability Act (HIPAA), focusing on the confidentiality and security of patient information.

Compliance 52

Compliance Compliance Officers HIPAA Governance 52

MedTrainer

SEPTEMBER 20, 2023

This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you want to obtain or retain CMS certification in order to be reimbursed by services provided to patients with a Medicare/Medicaid health plan, you must comply with HIPAA rules and regulations. Accreditation.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

YouCompli

DECEMBER 19, 2023

HIPAA Privacy and Security Rules (page 30): In bold print, the OIG recommends that compliance with Privacy, Security and Breach Notification Rule requirements be included in ALL risk assessments. Effective communication and collaboration between compliance and legal is the key to a successful outcome.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52