American Medical Compliance

JANUARY 9, 2024

The following Documentation and Provider Standards Training educates healthcare providers on the significance of documentation compliance in healthcare. It also provides an introduction to all things related to healthcare compliance, which is important for all healthcare facilities to know about.

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Compliancy Group

APRIL 25, 2024

Maintaining Medicare compliance and avoiding legal and financial repercussions requires Medicare compliance training for employees at all organizational levels. Examples of Medicare fraud include billing for unrendered services and using a billing code or a service that’s more expensive than what a patient received.

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American Medical Compliance

OCTOBER 25, 2024

Compliance isn’t just a box to check—it’s a vital responsibility that safeguards patient well-being and protects organizations from significant financial losses. A powerful way to ensure this is through regular compliance audits. This is to confirm that staff are properly trained in compliance protocols.

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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. We’ll discuss how regulatory compliance enables proper risk management and how risk assessment advances healthcare compliance.

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AIHC

SEPTEMBER 3, 2024

Celebrating the Healthcare Compliance Officer The American Institute of Healthcare Compliance is recognizing healthcare Compliance Officers – hats off to you! The primary goal of a compliance officer is to mitigate risk. This involves investigating complaints and conducting internal auditing and monitoring for compliance.

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American Medical Compliance

AUGUST 7, 2024

Notably, many of these incidents are preventable and could have been avoided with proper compliance measures. Compliance with healthcare regulations is crucial not only for avoiding legal repercussions but also for ensuring high standards of patient care and safety. It ensures its confidentiality and maintains security.

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Compliancy Group

DECEMBER 15, 2023

Differentiating Fraud, Abuse, and Waste Detecting and stopping fraud, abuse, and waste rely on distinguishing these behaviors in the healthcare context. What is Healthcare Fraud? Providers commit Medicare and Medicaid fraud when they knowingly submit or contribute to the submission of a false claim for financial gain.

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Compliancy Group

SEPTEMBER 16, 2024

Office of Inspector General (OIG) enforces the General Compliance Program Guidance. This comprehensive document governs patient care, worker safety, and privacy and confidentiality of protected health information (PHI). Compliance officers have access to more information about their responsibilities and roles.

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MedTrainer

JANUARY 10, 2024

It may seem a little early to do some spring cleaning, but not when it comes to compliance! It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. The OIG is making major investments to systematically detect and prosecute fraud.

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Compliancy Group

NOVEMBER 1, 2024

When you work in healthcare, you must comply with the most rigorous regulations that safeguard patient health and privacy, protect workers, and prevent fraud, waste, and abuse of federal funds. Anyone in this industry should know the healthcare compliance laws and regulations that guide how they do their jobs and provide quality care.

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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 Here is what was included in the charge document: More moles were removed that were medically necessary.

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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. What is an Audit in Healthcare?

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Compliancy Group

JULY 10, 2024

Compliance with healthcare regulations protects patients, safeguards employee safety, and maintains the security of electronic medical records (EMRs) and cyber networks. Ensuring compliance with critical regulations falls on the compliance officer. What Does a Compliance Officer Do?

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Compliancy Group

JULY 29, 2024

In 2024, home health agencies face stringent new compliance requirements as outlined by the Office of Inspector General (OIG). This guide provides an overview of the OIG compliance program guidance for home health agencies and practical steps for staying compliant.

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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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Compliancy Group

AUGUST 30, 2024

Ensuring compliance in your hospital, private practice, or healthcare company means safeguarding patient data, optimizing working conditions for employees, and promoting the highest quality of care. We suggest incorporating them into an annual compliance checklist for companies across the healthcare sector.

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Compliancy Group

JUNE 27, 2024

Completing compliance incident reports is crucial to reducing the number of accidents in the future and understanding why they occur. Understanding what incidents need reporting and how to complete an incident report can help providers, compliance officers, and other personnel maintain the highest safety standards.

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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. HIPAA, enacted in 1996, originally aimed to improve health insurance portability and reduce healthcare fraud. What Is HIPAA?

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Compliancy Group

FEBRUARY 28, 2024

Many industries have compliance rules and regulations to meet and follow, but few would argue that healthcare is one of the most stringent. Privacy and security – Compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations to protect patient privacy and data security is crucial.

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AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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Med-Net Compliance

OCTOBER 27, 2022

According to court documents and evidence presented at trial, the psychologist caused the submission of fraudulent Medicare claims from July 2016 through June 2019 for psychotherapy services purportedly provided to nursing home residents in Chicago and surrounding areas. The psychologist was convicted of four counts of healthcare fraud.

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MedTrainer

FEBRUARY 1, 2024

Those early ethical standards paved the way for how medical compliance plans to limit liability for healthcare organizations today. Here’s how these plans help limit liability: Prevent Fraud and Abuse: Compliance plans include measures to prevent fraud and abuse within the healthcare organization.

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Compliancy Group

JUNE 21, 2024

There seems to be a gap between chiropractic services and positive compliance outcomes. This is why an OIG compliance manual for chiropractors is essential. The purpose of an OIG audit is to prevent fraud and abuse or to detect it. These evaluations assess the effectiveness of departmental programs.

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Compliancy Group

MAY 15, 2024

As we move deeper into 2024, hospitals must increasingly focus on compliance with regulations set forth by the Office of Inspector General (OIG). This guide outlines the OIG’s hospital compliance priorities and provides actionable advice on ensuring your hospital meets these rigorous standards.

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MedTrainer

APRIL 22, 2024

Creating and using a supplier compliance checklist ensures vendors meet regulatory requirements and are trusted partners in managing sensitive information. In this article, I’ll discuss why supplier compliance is as critical as legal and regulatory adherence for healthcare organization employees.

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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. Remaining in good standing with Medicare has several advantages.

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Compliancy Group

JANUARY 22, 2024

Critical Components of a Healthcare Compliance Audit Checklist There are several necessary components in a comprehensive healthcare compliance audit checklist that help maintain adherence to regulatory standards. Documentation Review The first step in any healthcare audit is thoroughly reviewing all required documentation.

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Med-Net Compliance

JULY 11, 2022

The report says that in FY 2021 the DOJ opened 831 new criminal healthcare fraud investigations. Federal prosecutors filed criminal charges in 462 cases involving 741 defendants, and a total of 312 defendants were convicted of healthcare fraud related crimes during the year. 2,947 investigations were pending at the end of FY 2021.

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Med-Net Compliance

JULY 20, 2022

According to court documents and evidence presented at trial, the doctor billed Medicare and Medicaid for an incision procedure of the external ear for hundreds of patients, when in fact all he actually performed was an ear exam or ear wax removal. He was convicted of one count of healthcare fraud and one count of making a false claim.

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Med-Net Compliance

NOVEMBER 2, 2022

Massachusetts Attorney General Maura Healey announced that her office’s Medicaid Fraud Division recovered more than $71 million during the most recent federal fiscal year, which ended on September 30. The AG’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state’s Medicaid program, MassHealth.

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Healthcare Compliance Blog

APRIL 29, 2022

in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. Court documents show that between 2008 and 2016 the former owner defrauded the Texas Medicaid program by billing for items and services that had not been provided to the clients of the day care centers. US Attorney Ashley C.

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Compliancy Group

JULY 18, 2024

It’s becoming more well-known that billing is one of the most common compliance risk areas outlined by the Office of the Inspector General (OIG). The occurrence of these issues is consistent, and over time, they can result in thousands of dollars lost in compliance penalties. With the U.S.

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MedTrainer

OCTOBER 28, 2024

By understanding and implementing these key policies, you can equip your staff to effectively maintain compliance and accreditation, ultimately reducing the stress associated with the accreditation process. Even with all the policies in place, a lack of employee adherence can lead to gaps in compliance and control.

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MedTrainer

JANUARY 31, 2024

Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program? It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. What is Healthcare Compliance?

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MedTrainer

JANUARY 26, 2024

Non-compliance in healthcare refers to the failure of healthcare providers, institutions, or individuals to adhere to the laws, regulations, and standards established to protect patient welfare, maintain data security, and ensure the efficient and ethical delivery of healthcare services. What is Healthcare Compliance?

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MedTrainer

JANUARY 12, 2024

Healthcare compliance is serious business for regulators. In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. What is Healthcare Compliance? Who Regulates Healthcare Compliance?

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MedTrainer

FEBRUARY 1, 2024

A corporate compliance program in healthcare is a comprehensive set of policies, procedures, and practices that healthcare organizations establish and maintain to ensure that they operate compliant with all applicable laws, regulations, and ethical standards. Why do healthcare facilities use corporate compliance programs?

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