Healthcare Law Blog

FEBRUARY 9, 2024

million to resolve a lawsuit filed by the system’s former Chief Compliance Officer, Ronald Sherman. Sherman himself had submitted disclosure logs to the OIG), Sherman alleges that it failed to adequately report the arrangements it had with Neonatology Associates or any other private physician groups, or return any alleged overpayments.

Hospitals 52

Hospitals Compliance Officers Compliance Overpayment 52

YouCompli

NOVEMBER 1, 2023

As compliance officers, we are continually placed in a position to influence the actions of others and help shape our organization’s compliance culture. One way to change that perception is to avoid creating “gotcha” moments when you’re working on a compliance-related matter.

Compliance 52

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

YouCompli

SEPTEMBER 13, 2023

For staff, compliance officers should support annual online FWA compliance training. Step 3: Report Once any of the above activities are discovered, compliance officers should educate patients and staff on how to report FWA. This could include how to submit a hotline report on the HHS-OIG website.

US Department of Health and Human Services 52

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

YouCompli

FEBRUARY 22, 2023

Compliance officers can help protect revenue and reduce the risk of penalties by collaborating with the Finance and Reimbursement departments to navigate the dynamics of outlier payments and prospective repayment. Return illegitimate reimbursement and overpayments quickly. The government has a 60-day overpayment rule.

Compliance 52

Compliance US Department of Health and Human Services Overpayment Overpayments 52

YouCompli

MAY 17, 2023

Sharon Parsley, JD, MBA, CHC, CHRC contributes a regular post on compliance officer effectiveness for the YouCompli blog. What does it really take to ensure that an organization has a mature, well-integrated, and high-performing Compliance function? We further identified overpayments and developed a plan to refund.

Compliance 52

Compliance Compliance Officers Overpayment Overpayments 52

Compliancy Group

FEBRUARY 2, 2024

CIAs typically last five years and require organizations to Appoint a compliance officer or committee Allow for independent annual reviews of the program Establish a confidential disclosure program Formulate compliance policies and standards Ensure that only eligible individuals remain employed Provide comprehensive compliance training for all personnel (..)

Compliance 52

Compliance Overpayment Overpayments Compliance Officers 52

YouCompli

OCTOBER 26, 2022

That’s why we work so hard to simplify and streamline regulatory change management: we have to take the busy work out of compliance so that our clinical colleagues can apply their subject matter expertise to compliance, rather than getting overwhelmed with process. That’s a 41% error rate with an extrapolated overpayment of?$269

Compliance 52

Compliance Compliance Officers Overpayment Overpayments 52

YouCompli

DECEMBER 14, 2022

Sharon Parsley, JD, MBA, CHC, CHRC contributes a monthly post on compliance officer effectiveness for the YouCompli blog. Many people in our discipline love the slogan “compliance is everybody’s business.” Here, any overpayment from a governmental payer source must be returned within 60 days of its identification.

Compliance 52

Compliance Compliance Officers Nurses Overpayment 52

Hall Render

NOVEMBER 25, 2024

OIG called for nursing facilities to take proactive measures to ensure compliance with program rules, including conducting regular reviews to ensure billing and coding practices are current and accurate, as well as performing regular internal billing and coding audits. Compliance Officer Experience. Competency-Based Training.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

Compliancy Group

FEBRUARY 7, 2024

Through a combination of data analysis, investigations, medical reviews, and site visits, UPICs scrutinize healthcare providers and suppliers to ensure compliance with billing rules and the provision of medically necessary services. The outcome of these audits can range from repayment of overpayments to criminal prosecution in cases of fraud.

Fraud 52

Fraud Compliance Medicare Medicare 52

AIHC

APRIL 5, 2022

If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back. If your organization has a Compliance Officer and/or Certified Healthcare Auditor, you may want to bring concerning situations to his/her attention. If in doubt, check it out.

Fraud 52

Fraud Medicare Medicare Compliance 52

Health Law RX

JANUARY 30, 2024

Element 7 of the GCPG provides guidance regarding: (1) refunding overpayments, (2) enforcing disciplinary policies and procedures, and (3) making any policy or procedure changes necessary to prevent a recurrence of the misconduct. Ensure Ongoing Compliance.

Compliance 52

Compliance Due Diligence Fraud Governance 52

AIHC

OCTOBER 23, 2024

This responsibility usually falls on the organization’s Compliance Officer. Corrective action includes refunding overpayments revealed during the audit. Federal law requires entities repay any overpayments received from Medicare or a State Medicaid program within 60 days after identification.

Compliance 52

Compliance Overpayment Overpayments Medicaid 52