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Adhering to regulatory guidelines and ethical standards is of the utmost importance in every healthcare setting. 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 AI? Artificial intelligence is the science of making machines that can learn, similar to the ways humans do. AI technology can process large amounts of data in ways that humans can’t. Machines and programs that incorporate AI in their design are able to recognize patterns and make decisions based on their experience of a dataset and therefore their ability to predict what would come next in a pattern.
Academic medical centers often have unique risks associated with their services. As a result, their compliance programs need to be designed to account for these risks.
By: David Mordo, Senior Compliance Consultant, MZQ Consulting The IRS recently released Revenue Procedure 2023-29 , which declared that the Affordable Care Act (ACA) benchmark for determining the affordability of employer-sponsored health coverage will significantly decrease to 8.39% of an employee’s household income for the 2024 plan year. This almost three-quarters of a percentage point is a significant decrease for several reasons.
Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
A class action lawsuit against Meta Pixel, John Doe v. Meta Platforms Inc. , was filed in the U.S. District Court, Northern District of California, in June of 2022. In the lawsuit, Plaintiffs allege that Meta knew, or should have known, that its Pixel tracking tool was being improperly used on the websites of at least 600 hospital systems. Meta Pixel Privacy Lawsuit: Targeting Meta Plaintiffs claim that the hospital systems were sending protected health information to Facebook through the Pixel
The HHS’ Office for Civil Rights released guidance in 2022 on HIPAA and website tracking technologies and confirmed disclosures of protected health information to third parties via website tracking technologies is a HIPAA violation unless authorization has been received from patients or if there is a valid business associate agreement in place. OCR and the Federal Trade Commission also wrote to 130 healthcare and telehealth providers to warn them about tracking technologies on their websites and
Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. An audit by the U.S. Health and Human Services Office of Inspector General (OIG) found that Medicare beneficiaries used 88 times more telehealth services during the first year of the pandemic than they did the previous year.
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Health Care Compliance Brief brings together the best content for health law & compliance professionals from the widest variety of industry thought leaders.
Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. An audit by the U.S. Health and Human Services Office of Inspector General (OIG) found that Medicare beneficiaries used 88 times more telehealth services during the first year of the pandemic than they did the previous year.
As the healthcare industry constantly evolves, staying compliant with regulations is critical for both patients and providers. The complex nature of healthcare regulations necessitates the need for specialized services to help organizations navigate through this intricate landscape. We will explore the importance of healthcare regulatory services, the healthcare compliance resources they provide, and how healthcare regulatory advisory services can benefit both patients and providers.
Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If it is too good to be true it probably isn't.” This article is educational only, and does not provide consulting or legal advice.
Compliance with regulatory requirements is not just a necessity for healthcare providers; it’s a critical component of providing safe and ethical care to patients. Healthcare organizations therefore face myriad complex regulations. Ensuring compliance can be a daunting task, but healthcare compliance software is available to simplify the process and help organizations meet their regulatory obligations with ease.
Covenant Health expanded its high acuity care hospital-at-home program in Knoxville, Tennessee, on Tuesday. WHY IT MATTERS A suite of electronics is enabling patients from Fort Sanders Regional Medical Center facility and now Parkwest Medical Center with chronic obstructive pulmonary disease, pneumonia, cellulitis and more to recuperate at home, according to a local WATE ABC6 report.
Based on comprehensive survey data from diverse healthcare providers, the 2025 HIPAA Benchmark Report delivers actionable intelligence for modern compliance programs. This report examines how organizations are restructuring HIPAA Privacy Programs to address emerging regulatory requirements. Through analysis of staffing models, program operations, and breach management protocols, it provides a clear picture of current best practices.
The departure of Brewer, a veteran of retailers Starbucks and Walmart, comes as Walgreens looks to beef up its leadership roster with healthcare executives.
Following conversations in Washington and state capitals, the American Telemedicine Association published its new Health Data Privacy Principles this week. They're meant to address concerns about state privacy laws governing consumer health data, according to ATA, which is urging policymakers to ensure conditions that stimulate innovation and advance patient access to virtual care.
By Karey Harwood For as long as I have been thinking and writing about egg freezing, its characterization as “a technological solution to a social problem” has adumbrated a core criticism: egg freezing falls short because there is a deeper problem it doesn’t solve. Egg freezing may help the individual woman who can afford it, yes, but not much more.
Anjali Kataria, Mytonomy CEO and cofounder, says that content streaming and AI can empower patients at home and help hospitals and health systems improve their patient education materials as they reduce the time nurses spend answering questions.
Every health care provider that accepts federal payments must screen for excluded providers. Use this sample Exclusion Screening Checklist and Compliance Policy to evaluate and improve your organization’s compliance with the law. Payments from Medicare, Medicaid, and TriCare trigger screening requirements that may extend to employees, contractors, volunteers, board members, and network providers.
In the employer-sponsored insurer market, employers play a “critical” role when it comes to quality and outcomes, according to a report by Morgan Health and Embold Health.
Clínica Alemana Osorno, located in southern Chile, has introduced digital communication workflows that leverage connected care. Digital workflows are helping the clinic create a better patient experience, enhance workforce efficiency and increase access to care across its 46 medical specialties and four facilities. With more than 300,000 outpatient appointments per year, Clínica Alemana Osorno is one of the largest healthcare providers in southern Chile.
Enforcement of information blocking penalties for health IT entities is slated to go into effect on Friday, opening the door to penalties of up to $1 million per violation. | The Department of Health and Human Services Office of Inspector General said it expects to receive more complaints than it can investigate and so will be prioritizing those meeting certain criteria.
Saudi Arabia's Ministry of National Guard Health Affairs broke records by achieving HIMSS stage 7 in four models concurrently. Raed Alhamze explores the impact on patient outcomes.
Payroll compliance is a cornerstone of business success, yet for small and midsize businesses, it’s becoming increasingly challenging to navigate the ever-evolving landscape of federal, state, and local regulations. Mistakes can lead to costly penalties and operational disruptions, making it essential to adopt advanced solutions that ensure accuracy and efficiency.
The program builds on Humana’s acquisition of home-based primary care provider Heal earlier this year, and could eventually expand to 10 additional southern and southwestern states.
Humana's senior-focused primary care business, CenterWell, is bringing its services into patients' homes. | Humana's senior-focused primary care business, CenterWell, is bringing its services into patients' homes.
Healthcare communication has evolved from handwritten notes and paper charts to digital tools like EHRs, telemedicine, and AI-powered platforms. This blog explores how these advancements improve patient outcomes, streamline care delivery, and enhance provider collaboration. Learn about the role of mobile health (mHealth) apps, secure messaging, and social media in bridging communication gaps.
The South Carolina-based health system alleges that the insurer broke its contract and gave "false and misleading" statements to the press about Prisma’s proposed rates for 2024.
The commitment to telehealth from CMS offers medical specialties the freedom to innovate and provide better and more equitable care, says Dr. Robert Murry, chief medical officer of NextGen Healthcare and a practicing family physician.
In a letter sent to all states (PDF), the Centers for Medicare & Medicaid Services ( | As more Medicaid beneficiaries are wrongly kicked off the program, CMS is requiring states to reevaluate its eligibility systems and auto-renewal process.
At an EGM on Thursday members of the Faculty of Clinical Informatics (FCI) passed a motion of no confidence in the leadership of the Board of Trustees.
In healthcare, where patient data protection is paramount, effective vendor risk management isn't just good business—it's essential for maintaining compliance and trust. This comprehensive guide helps healthcare compliance professionals navigate the complexities of third-party vendor relationships in an increasingly interconnected healthcare environment.
A limited group of Google Cloud clients, including systems HCA and Mayo Clinic, have been testing the large language model since April in a variety of use cases.
The Acute Hospital Care at Home waiver program from the Centers for Medicare & Medicaid Services has grown to 125 health systems and 289 hospitals in 37 states in less than three years. A number of other health systems and hospitals have secured waivers but haven't yet implemented a program. Others haven't scaled, because they are discovering that managing all the clinical and nonclinical services associated with hospital-level care in the home is a major undertaking.
GoodRx has launched a new feature to allow healthcare professionals to see the cost of a patient’s prescription with their insurance. | The feature, embedded in GoodRx's provider solution, surfaces a patient’s coverage and benefits at the point of care with the goal of increasing price transparency and access to drugs.
The health care industry has undergone a significant transformation with the widespread adoption of EHRs and the electronic exchange of patient information. In the wake of digitization, the release of information (ROI) process has also changed and will continue to advance for the foreseeable future.
Let's discuss the trusty pager—an old favorite that’s losing its shine in hospitals and clinics. While once a staple in hospitals and clinics, pagers now present significant limitations that hinder rather than facilitate communication among healthcare professionals. Healthcare professionals are constantly on the move, and they need communication tools that can keep up with their fast-paced lives.
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