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. A federal district court judge will determine any sentence after considering the US Sentencing Guidelines and other statutory factors.

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

Healthcare Compliance Blog

MAY 9, 2022

A home health services company headquartered in Kentucky, and its related entities, paid $2.1 million to the United States government to settle claims of improperly billing the Medicare Program for home health services provided to beneficiaries living in Florida.

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US Department of Health and Human Services Medicare Medicare Compliance 59

Compliancy Group

JULY 24, 2024

One of the most significant regulatory bodies is the Centers for Medicare & Medicaid Services (CMS), which conducts rigorous inspections to ensure that healthcare providers meet required standards. Understanding CMS Inspections CMS is a federal agency within the United States Department of Health and Human Services.

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US Department of Health and Human Services Compliance Medicaid Medicaid 59

Total HIPAA

JANUARY 18, 2022

HIPAA breaches involving fewer than 500 individuals which occurred during 2021 must be reported to the US Department of Health and Human Services (HHS) by Tuesday, March 1, 2022. Here are a few examples from the HHS website: A municipal social service agency disclosed PHI while processing Medicaid applications.

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HIPAA US Department of Health and Human Services Compliance Medicaid 92

Compliancy Group

JUNE 6, 2024

Many compliance violations in healthcare arise from financial conflicts of interest, particularly when providers get kickbacks or achieve financial gain from their referral services. Department of Health and Human Services, enforces the Stark Law. CMS Updates in 2023 : Voluntary self-referral disclosure laws.

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Compliance Officers Compliance US Department of Health and Human Services Medicare 59

Med-Net Compliance

OCTOBER 19, 2022

The settlement resolves allegations that between 2013 and 2020, the company paid remuneration to its home health medical directors in Oklahoma and Texas for the purpose of inducing referrals of Medicare and TRICARE home health patients. The corporate officers were previously the CEO and COO of the company.

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US Department of Health and Human Services Medicare Medicare Medicaid 59

Med-Net Compliance

NOVEMBER 8, 2022

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections).

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

Healthcare Law Blog

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

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US Department of Health and Human Services HIPAA Medicaid Medicaid 52

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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Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Healthcare IT Today

JANUARY 10, 2024

As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. Jason Considine, Chief Commercial Officer at Experian Health Staffing shortages will continue to be a major pain point for providers in 2024 and have a direct impact on their bottom line.

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US Department of Health and Human Services Nurses Hospitals Telemedicine 97

Med-Net Compliance

SEPTEMBER 20, 2022

million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. According to court documents and evidence presented at trial, the podiatrist was revoked from participating in the Medicare program in January 2015.

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Fraud US Department of Health and Human Services Medicare Medicare 59

Med-Net Compliance

AUGUST 18, 2022

An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.? Document that these trainings occurred and file the signed document in each employee’s education file.

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

Med-Net Compliance

JULY 19, 2022

In order to participate in the Medicare, Medicaid, and all federal healthcare programs once the term of exclusion ends, the individual or entity must apply for reinstatement and receive written notice from OIG that reinstatement has been granted. An individual or entity with a defined period of exclusion (e.g., 5 years, 10 years, etc.)

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US Department of Health and Human Services Licensing Medicare Medicare 59

Compliancy Group

FEBRUARY 28, 2024

Within the US Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) is responsible for overseeing and administering various healthcare programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

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Compliance US Department of Health and Human Services Fraud Medicare 52

C&M Health Law

JANUARY 20, 2023

This builds on the HIPAA Transactions Rule standards for financial and administrative transactions among health care providers and health plans and aligns with Department of Health and Human Services (HHS) interoperability regulations.

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HIPAA US Department of Health and Human Services Compliance Health Insurance 52

Med-Net Compliance

JULY 25, 2022

The Office for Civil Rights (OCR) at the US Department of Health and Human Services (HHS) announced the resolution of eleven investigations in its Health Insurance Portability and Accountability Act (HIPAA) Right of Access Initiative, bringing the total number of these enforcement actions to thirty-eight since the initiative began.

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

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. Ensuring proper creation, maintenance, distribution, and storage of documentation. Reimbursement. Healthcare administration.

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

Compliancy Group

JANUARY 17, 2024

Understanding the OIG Work Plan The OIG Work Plan for physicians and health organizations is a dynamic document that lays out the various audits, reviews, and inspections the OIG intends to conduct in relation to healthcare programs and services within a time frame. OIG in healthcare , functioning as an arm of the U.S.

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

Compliancy Group

MARCH 19, 2024

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number).

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

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

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US Department of Health and Human Services Medicare Medicare Medicaid 52

AIHC

NOVEMBER 15, 2022

Written by Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS The Federal Hospital Price Transparency Rule helps Americans know the cost of a hospital item or service before receiving it. In the US, hospital prices vary widely but are not visible to patients or the public.

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Hospitals US Department of Health and Human Services Compliance Governance 52

YouCompli

FEBRUARY 22, 2023

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. 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.

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Compliance US Department of Health and Human Services Overpayments Overpayment 52

Physician Credentialing Company

OCTOBER 17, 2024

In the healthcare sector, healthcare organizations and practitioners provide medical services to patients and ask for reimbursement in return from the insurers. There are many codes assigned for the service provided to the patients, and CPT code 99214 is very important for billing office or outpatient medical patient visits.

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US Department of Health and Human Services Medical Billing Medicare Medicare 40

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.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

MedTrainer

FEBRUARY 13, 2022

During the credentialing procedure, a candidate’s documentation is sent back to the institution that first issued them, such as a university to confirm their legitimacy. After all, there is a bit of a loophole under the Incident-to rule that allows a non credentialed physician to bill under a credentialed physician for services.

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US Department of Health and Human Services Medical Billing Hospitals Compliance 40

MedTrainer

AUGUST 8, 2022

During the credentialing procedure, a candidate’s documentation is sent back to the institution that first issued them, such as a university to confirm their legitimacy. After all, there is a bit of a loophole under the Incident-to rule that allows a non credentialed physician to bill under a credentialed physician for services.

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US Department of Health and Human Services Medical Billing Hospitals Compliance 40

Healthcare IT News - Telehealth

JUNE 4, 2021

But for health IT, things sped up. When new technologies were needed to solve fast-moving healthcare challenges, hospitals and health systems could not afford to wait the time it normally took to stand up IT. This is the ninth installment in Healthcare IT News ' Health IT Lessons Learned in the COVID-19 Era feature story series.

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US Department of Health and Human Services COVID-19 Doctors COVID-19 Vaccine 190

HIT Consultant

FEBRUARY 24, 2025

The Healthcare Information and Management Systems Society (HIMSS) annual conference is upon us, and this year, the spotlight is firmly on AI. healthcare system from fee-for-service to value-based care. Soon, it will be hard to stay in a hospital for any length of time without seeing a robot.

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US Department of Health and Human Services Hospitals Governance Medicaid 75

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. Cobra breeders killed the majority of the cobras and redeemed them for money while they continued to breed more cobras.

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Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. Cobra breeders killed the majority of the cobras and redeemed them for money while they continued to breed more cobras.

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Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Hall Render

JULY 26, 2024

How hospitals can mitigate the damage. How hospitals can mitigate the damage.

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US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

Hall Render

JULY 26, 2024

How hospitals can mitigate the damage. How hospitals can mitigate the damage.

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US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

Hall Render

JUNE 7, 2024

News ranks hospitals in health equity. These hospitals earn top honors. These hospitals earn top honors. facility Southern Research CEO talks biotech incubator, future of Birmingham medicine ALASKA Juneau’s hospital is bleeding cash. list includes 3 from Arizona ARKANSAS Children’s Miracle Network Raises $5.4M

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US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

JUNE 21, 2024

NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. The deal fell through, but that won’t solve Bartlett’s budget issues. Kenai Peninsula Borough Assembly considers $38.5M Kenai Peninsula Borough Assembly considers $38.5M

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

JUNE 28, 2024

NATIONAL 50% of physicians are thinking of leaving the field due to shortage AHA backs bid to repeal nursing home staffing rule AHA wins lawsuit against HHS over third-party web tracking AHA responds to study blaming hospital prices for societal issues AHA slams study tying unemployment to hospital price increases Behind the battle against corporate (..)

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

FEBRUARY 2, 2024

Vincent North in Sherwood Washington Regional Medical System Names Lucas Campbell as VP & Chief Transformation Officer 4 more Arkansas hospitals awarded federal funds Arkansas Legislative Council approves Department of Human Services’ requests for $13.4M Opens in North Little Rock CHI St.

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Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

SEPTEMBER 20, 2024

Mesa hospital Phoenix bioscience boom poised to improve health care and local economy, proponents say What’s next for Steward hospitals in Arizona? Federal Grant to Study Eye Disease UAMS Study to Address Maternal, Infant Deaths with $2.4M

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US Department of Health and Human Services Nurses Hospitals Nursing Homes 40