Verisys

DECEMBER 13, 2023

Healthcare Fraud Crackdown! Each month we will give a roundup of recent healthcare fraudsters and compliance busters. With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network.

Fraud 52

Fraud Telemedicine Licensing Compliance 52

Provider Trust

AUGUST 6, 2024

Healthcare compliance monitoring has never been easy. So, what makes an effective compliance monitoring program? The compliance spectrum helps organizations of all sizes identify the effectiveness of their compliance monitoring based on three key factors: population, primary sources, and frequency. What about vendors?

Compliance 52

Compliance Licensing Fraud 52

American Medical Compliance

APRIL 6, 2023

Prosecutors stated that if they passed, they would be able to seek licenses and jobs in numerous locations. Incidence of Healthcare Fraud Numerous scammers view this as a method to make quick, yet unlawful, money. Incidence of Healthcare Fraud Numerous scammers view this as a method to make quick, yet unlawful, money.

Fraud 52

Fraud Nurses Licensing Compliance 52

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.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Verisys

FEBRUARY 8, 2024

Verisys can assist pharmaceutical manufacturers in maintaining compliance with OIG guidelines and other regulatory requirements through a multifaceted approach, leveraging its extensive suite of data solutions and compliance services. The post Pharmaceutical Manufacturers Guide to OIG Compliance appeared first on Verisys.

Compliance 52

Compliance Licensing Fraud 52

Provider Trust

APRIL 18, 2024

This comprehensive program provides healthcare organizations across the continuum of care a roadmap to implement top-tier compliance standards by addressing key population monitoring gaps, prioritizing financial efficiencies, and upholding community healthcare and success.

Compliance 52

Compliance Licensing Fraud Medicaid 52

Provider Trust

APRIL 26, 2023

Compliance and HR managers responsible for staffing should stay apprised of events that may have repercussions within the healthcare space. However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. This can spell trouble for everyone involved.

Licensing 52

Licensing Nurses Compliance COVID-19 52

Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. The psychologist was convicted of four counts of healthcare fraud.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

MedTrainer

FEBRUARY 12, 2024

Failing to report healthcare non-compliance is a lot like failing to tell your parents you got sent to the principal’s office. In this blog, we’ll outline why reporting healthcare non-compliance is non-negotiable and how software platforms make it easier to stay in compliance with the myriad regulations that govern good healthcare.

Compliance 52

Compliance Licensing Governance Fraud 52

MedTrainer

JULY 31, 2024

Meeting Tennessee training requirements for compliance is critical to maintain this level of excellence. What Is Required for Tennessee Compliance Training? Healthcare compliance training is not a one-size-fits-all solution. Provide required and often hard-to-find CE courses for licensed employees.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

Provider Trust

JUNE 1, 2022

Organizations across the healthcare continuum have experienced several workforce trends that are creating gaps in license monitoring and verifications. In this post, we’ll explore three current challenges impacting the healthcare license and credential verification process.

Licensing 52

Licensing Nurses COVID-19 Compliance 52

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?

Compliance 52

Compliance Fraud Medicaid Medicaid 52

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.

Compliance 52

Compliance HIPAA Licensing Fraud 52

MedTrainer

JULY 30, 2024

What Is Required for Wisconsin Compliance Training? Healthcare compliance training is not a one-size-fits-all solution. Here’s what you should look for when selecting healthcare compliance courses: Healthcare-Specific Content: Scenario-based training is required in many states and it is also one of the most effective ways to learn.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

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. Compliance Assessment Ensuring compliance with applicable laws and regulations is fundamental to any healthcare audit.

Compliance 52

Compliance Fraud Regulatory Compliance HIPAA 52

Verisys

MARCH 1, 2024

As the healthcare industry is increasingly targeted for data theft and fraud, information security has emerged as a top priority for healthcare institutions. Governance, risk management, and compliance programs can all be automated, providing significant benefits to healthcare organizations.

Governance 52

Governance Compliance Fraud HIPAA 52

Provider Trust

MARCH 13, 2023

State licensing boards nationwide have annulled the licenses of dozens of nurses who obtained fake degrees and used them to gain or secure employment. In Delaware, 26 nursing licenses were revoked when the nurses’ credentials were tied to the scheme. Are you in Florida? What are your pre-hire practices?

Fraud 52

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

MedTrainer

SEPTEMBER 10, 2024

When talking about healthcare compliance education, these misunderstandings can have significant repercussions, from compliance gaps to inefficiencies in operations. Understanding common, but dangerous misconceptions about healthcare compliance education can potentially prevent your organization from these issues in the long run.

Compliance 52

Compliance Compliance Officers HIPAA Medicare 52

MedTrainer

JUNE 11, 2024

What Is Required for Texas Compliance Training? Healthcare compliance training is not a one-size-fits-all solution. Here’s what you should look for when selecting healthcare compliance courses: Healthcare-Specific Content: Scenario-based training is required in many states and it is also one of the most effective ways to learn.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

MedTrainer

JANUARY 12, 2024

At its core, healthcare compliance ensures the quality of care, patient safety, and integrity of healthcare systems. Over the years, healthcare compliance has evolved significantly, driven by changing regulations, advances in technology, and a growing emphasis on patient-centric care. What is Healthcare Compliance?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

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. The OIG and prosecutors look for evidence of “lessons learned”, as outlined in an the U.S.

Fraud 52

Fraud Compliance Compliance Officers Licensing 52

MedTrainer

JUNE 11, 2024

What Is Required for Florida Compliance Training? Healthcare compliance training is not a one-size-fits-all solution. Here’s what you should look for when selecting healthcare compliance courses: Healthcare-Specific Content: Scenario-based training is required in many states and it is also one of the most effective ways to learn.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

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?

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

Verisys

MAY 9, 2023

Data Compliance: 3 Focus Areas for Mitigating Organizational Risk A three-part compliance series that focuses on using technology to help you achieve your compliance goals. There is no question that healthcare organizations should have an effective healthcare compliance program.

Compliance 52

Compliance Fraud Governance Licensing 52

MedTrainer

OCTOBER 4, 2023

To ensure organizations meet these standards, federal healthcare compliance requirements have been put in place. These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. What Are Federal Healthcare Compliance Requirements?

Compliance 52

Compliance Fraud HIPAA Governance 52

MedTrainer

AUGUST 31, 2023

Yet, navigating the intricacies of healthcare compliance can be daunting. It’s why we’ve compiled a series of the most common healthcare compliance FAQs and their answers. Any healthcare professional curious about compliance practices will find these answers helpful, insightful, and empowering. What Is Healthcare Compliance?

Compliance 52

Compliance Compliance Officers HIPAA Fraud 52

Healthcare IT News - Telehealth

JUNE 8, 2022

based attorney in the health law practice of Baker, Donelson, Bearman, Caldwell & Berkowitz about what providers should be doing to ensure compliance when the PHE finally sunsets. What do you see as the primary compliance issues providers will have to contend with? We spoke recently with Allison M. Cohen, a Washington, D.C.-based

US Department of Health and Human Services 182

US Department of Health and Human Services Compliance COVID-19 Overpayments 182

Verisys

SEPTEMBER 28, 2023

Verisys introduced the Fraud Abuse Control Information System (FACIS) to meet this growing need in 1993. Initially, FACIS aggregated data from licensing boards, the Office of Inspector General (OIG), and other select federal databases. Here are four reasons why compliance experts at major healthcare organizations choose FACIS. #1

Compliance 52

Compliance Licensing Fraud 52

Compliancy Group

OCTOBER 1, 2024

Compliance officers and other organizational leaders must be constantly vigilant of resource waste and the inappropriate and illegal use of funds from Medicare and other federal programs. Compliance with Medicare and other programs requires relevant staff to take regular fraud, waste, and abuse (FWA) training.

Fraud 52

Fraud Compliance Medicare Medicare 52

Verisys

JUNE 8, 2023

Data Compliance: How to Identify and Close Data Risk Gaps Using Technology A three-part compliance series that focuses on using technology to help you achieve your compliance goals. Hiring a provider with red flags, even if in the past, can put your organization at risk for non-compliance.

Compliance 52

Compliance Fraud Licensing Medicare 52

MedTrainer

SEPTEMBER 5, 2024

In an effort to prevent fraud, the Drug Enforcement Agency (DEA) implemented additional security for their Registrant Validation Toolset. The post DEA Verification Change Resulting in Non-Compliance appeared first on MedTrainer. See how it works in this one-minute video. And then, reach out to MedTrainer to learn more.

Compliance 52

Compliance Fraud Licensing 52

Compliancy Group

MARCH 25, 2024

In today’s complex healthcare landscape, compliance is crucial. A healthcare compliance due diligence checklist is one essential tool that can help organizations in their quest for compliance. What is a Healthcare Compliance Due Diligence Checklist? What is a Healthcare Compliance Due Diligence Checklist?

Due Diligence 52

Due Diligence Compliance Informed Consent Fraud 52

Verisys

JULY 27, 2023

Achieving Transparency: How to Close A Critical Gap in Healthcare Compliance Continuous Data Monitoring is Key to Patient Safety Employing quality providers results in better patient outcomes. The safety of your patients depends on making sound hiring decisions and ensuring that the licenses of your staff are current.

Compliance 52

Compliance Due Diligence Licensing Fraud 52

MedTrainer

OCTOBER 16, 2023

This is the essence of corporate compliance in healthcare. Just as every piece of the puzzle must fit perfectly, every compliance element in healthcare needs precise integration to ensure seamless, ethical, and effective operations. Dive with us as we explore the complexities and necessities of compliance in the healthcare sector.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Medicaid 52

Verisys

JULY 5, 2023

Achieving Transparency: How to Close a Critical Gap in Healthcare Compliance Continuous Data Monitoring is Key to Patient Safety Employing quality providers results in better patient outcomes. The safety of your patients depends on making sound hiring decisions and ensuring that the licenses of your staff are current.

Compliance 52

Compliance Due Diligence Licensing 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. That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital.

Fraud 98

Fraud Compliance Medicaid Medicaid 98