Provider Trust

MAY 17, 2022

Federal regulators such as the HHS-OIG, the Department of Justice (DOJ), the Centers for Medicare and Medicaid Services (CMS), and others have regulations and guidelines regarding the prohibition of reimbursements of federal healthcare dollars (Medicaid, Medicare, CHIPS, TriCare, and others) to excluded vendors.

Compliance 52

Compliance Medicare Medicare Due Diligence 52

Healthcare IT Today

JANUARY 8, 2024

Streamlining Due Diligence with AI: AI technologies will likely be crucial in conducting efficient and thorough due diligence, examining potential M&A targets in the biotech industry for their scientific innovation, financial stability, and market compatibility.

Pharmaceutical Industry 92

Pharmaceutical Industry Due Diligence Compliance Regulatory Compliance 92

HIPAA Journal

MARCH 20, 2025

These data highlight the importance of securing the supply chain, conducting due diligence on vendors before their products and services are used, and monitoring existing vendors for HIPAA Security Rule compliance and cybersecurity. Dominion National Insurance Company, and Dominion Dental Services USA, Inc.

HIPAA 111

HIPAA Ransomware Compliance Hospitals 111

Verisys

NOVEMBER 30, 2023

Therefore, due diligence requires background checks to identify both current and historical adverse actions be performed. Hospital and health systems will be held accountable for a physician’s omission. Mistake No. 7: Failing to report adverse actions to the National Practitioners Data Bank (NPDB).

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

Verisys

FEBRUARY 4, 2022

Therefore, due diligence requires background checks to identify both current and historical adverse actions be performed. Exclusions from participation in a federal or state healthcare program including Medicare and Medicaid exclusions. Hospital and health systems will be held accountable for a physician’s omission. Mistake No.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

Provider Trust

MAY 18, 2022

In addition, the suit involved alleged submission of false claims for reimbursement to the Massachusetts Medicaid Agency. Bay Mental Health Centers (hereinafter referred to as “South Bay”) employee involving false claims for reimbursement of services provided by unlicensed and improperly supervised social workers and counselors at South Bay.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

MedTrainer

AUGUST 2, 2023

Insurance Reimbursement Insurance companies — along with government programs like Medicare and Medicaid — require providers to be credentialed to ensure they meet specific standards and qualifications. Selecting a credentialing provider takes a fair amount of due diligence; however, it’s time and energy that pay for themselves in short order.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Healthcare Law Blog

MAY 2, 2023

On April 12, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released a final rule updating key regulations pertaining to Programs of All-Inclusive Care for the Elderly (“PACE”) (the “ Final Rule ”). Overall, these changes, summarized below, will offer significant administrative and operational flexibilities.

Due Diligence 52

Due Diligence Medicaid Medicaid Medicare 52

Health Care Law Brief

NOVEMBER 9, 2021

Additionally, the Part II Rule provides that providers or facilities who act in good faith and with reasonable due diligence will not fail to comply with these requirements upon making an error in a good faith estimate, provided that they correct the information as soon as practicable. 2] See 86 Fed.

Medical Billing 75

Medical Billing Due Diligence Compliance Patient Satisfaction 75

HIPAA Journal

JANUARY 31, 2024

CA Healthcare Provider 2,364,359 Hackers hack access to its network between August 30, 2023, and September 1, 2023 Centers for Medicare & Medicaid Services MD Health Plan 2,342,357 MOVEit Transfer vulnerability exploited at Maximus Inc.

Ransomware 128

Ransomware HIPAA Hospitals Compliance 128

Hall Render

JANUARY 11, 2023

For example, reimbursement under Medicare and Medicaid for certain telemedicine services was significantly increased due to the COVID-19 pandemic.

Compliance 40

Compliance HIPAA FDA Due Diligence 40

AIHC

JUNE 22, 2022

If the provider is not enrolled in the plan, you will not be able to bill for services rendered, ESPECIALLY with Medicare and Medicaid. Code of Federal Regulations (CFR) have, as a result, become the best standard for due diligence. CFR regulations (U.S.

Medicaid 52

Medicaid Medicaid Due Diligence Medicare 52

HIPAA Journal

MAY 29, 2023

Risk management processes also need to be extended to third parties – business associates – which means performing due diligence on vendors throughout the supply chain and implementing processes to identify, assess, and manage vendor risk at each stage of the vendor life cycle – onboarding, ongoing, and offboarding.

HIPAA 107

HIPAA Compliance Due Diligence COVID-19 107