Compliancy Group

APRIL 8, 2024

Patient safety and regulatory compliance are paramount, and healthcare organizations face numerous challenges in effectively managing their operations. The complex nature of the healthcare industry calls for a robust framework to ensure governance, mitigate risks, and maintain compliance with various regulations.

Governance 52

Governance Compliance Regulatory Compliance Fraud 52

MedTrainer

JULY 31, 2024

Healthcare organizations of all sizes and types are increasingly adopting governance, risk, and compliance (GRC) frameworks to address the industry’s complex regulatory landscape and evolving challenges. The integration of GRC programs in healthcare has been significantly bolstered by technological advancements.

Governance 52

Governance Compliance HIPAA Regulatory Compliance 52

Health Care Law Brief

JULY 21, 2022

On July 20, 2022, the Office of Inspector General for the Department of Health and Human Services (“ OIG ”) issued a special fraud alert (“ Alert ”) advising “practitioners to exercise caution when entering into arrangements with purported telemedicine companies.” OIG Flags Seven Characteristics of Telehealth Fraud.

Fraud 52

Fraud Telemedicine COVID-19 Governance 52

Healthcare IT Today

DECEMBER 26, 2024

Recent incidents involving fake video calls and voice cloning demonstrate the technology’s potential for sophisticated fraud. Patient-centric access controls enabling granular data privacy protections will also be key to maintaining trust and regulatory compliance.

US Department of Health and Human Services 93

US Department of Health and Human Services Ransomware Compliance Hospitals 93

Verisys

FEBRUARY 14, 2024

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is healthcare data governance?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Health Law RX

JANUARY 30, 2024

By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The GCPG further explains how to implement these elements.

Compliance 52

Compliance Due Diligence Fraud Governance 52

HIT Consultant

MAY 4, 2023

But with so many competing training programs — everything from HIPAA and regulatory compliance to handwashing and job-specific training — it’s difficult to break through the noise and gain traction. The answer is training, continual training to help create a culture of security within your hospital or health system.

Hospitals 97

Hospitals HIPAA Regulatory Compliance Compliance 97

Compliancy Group

AUGUST 2, 2023

As the healthcare industry grows and changes, organizations face increasing challenges regarding compliance and risk management. Healthcare GRC (Governance, Risk, and Compliance) is a crucial framework that helps healthcare providers navigate these complexities effectively.

Compliance 52

Compliance Regulatory Compliance Governance Fraud 52

Verisys

NOVEMBER 30, 2022

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. Excluded from one means excluded from all, and the fines for non-compliance will likely be in the hundreds of thousands. How many data sources is your organization monitoring? And Thousands More….

Medicare 52

Medicare Medicare Regulatory Compliance Medicaid 52

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?

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 52

MedTrainer

JULY 29, 2024

These tools make it easier for healthcare organizations to maintain a culture of compliance, adapt to evolving industry standards, and ensure that all staff members are consistently informed and compliant. Corporate Compliance vs. Regulatory Compliance Corporate compliance and regulatory compliance are not the same thing.

Compliance 52

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

Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. Generally, compliance officers ensure that OIG internal monitoring and auditing.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Verisys

JANUARY 8, 2024

A healthcare compliance audit is a thorough review and examination of an organization’s adherence to regulatory guidelines. This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

Compliancy Group

OCTOBER 4, 2024

Maintaining the security and integrity of sensitive information and preventing waste, fraud, and abuse is essential to quality healthcare and promoting workplace safety. We also discuss how compliance software can help ensure regulatory compliance and maximize efficiency and accuracy in all your compliance activities.

Compliance Officers 59

Compliance Officers Compliance Regulatory Compliance Fraud 59

Compliancy Group

JANUARY 23, 2024

Understand Compliance Landscape Before you can write a comprehensive compliance plan, it’s crucial to grasp the intricacies of the healthcare compliance landscape. Various laws, regulations, and industry standards govern this sector. The primary goal?

Compliance 52

Compliance Regulatory Compliance Governance Fraud 52

MedTrainer

JANUARY 26, 2024

To answer the question “how does compliance have an impact on financial management in healthcare,” we first need to explore the connections between the two. What is Healthcare Compliance? Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry.

Compliance 52

Compliance Fraud Regulatory Compliance Health Insurance 52

Innovaare Compliance

JUNE 8, 2023

These changes, which went into effect on January 1, 2023, are designed to ensure health plans are accurately reporting their costs and that they are not overcharging the government. The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

MedTrainer

AUGUST 30, 2023

Some key compliance elements for managed care organizations include: Legal and Regulatory Compliance. MCOs must adhere to federal (Medicare) and state (Medicaid) laws and regulations governing the healthcare industry. Quality of Care Standards.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Compliancy Group

OCTOBER 2, 2023

This allows them to take corrective actions promptly and avoid penalties or legal repercussions arising from non-compliance. Compliance reporting in healthcare plays a significant role in upholding regulatory compliance standards, including in the following areas.

Compliance 52

Compliance Regulatory Compliance Fraud Health Insurance 52

HIT Consultant

JANUARY 3, 2023

But they have also expanded the attack surface at these organizations and increased the level of risk and vulnerabilities that could result in direct loss of proprietary information, direct financial damage including theft and fraud, and potential loss of life (in addition to regulatory fines and brand damage) the healthcare sector faces.

Compliance 52

Compliance Ransomware Fraud Regulatory Compliance 52

Healthcare Law Today

DECEMBER 12, 2022

In this episode of Health Care Law Today, Nate Lacktman and Maureen Stewart are joined by Mark Josephs, Deputy General Counsel of LifeMD to discuss the current regulatory and legal environment for telemedicine companies regarding online subscription services, and the recent investigations by the federal government of these services.

Telemedicine 49

Telemedicine Fraud Governance Compliance 49

Florida Health Care Law Firm

DECEMBER 2, 2021

On November 8, 2021, The Department of Health & Human Services (HHS), Office of Inspector General (OIG) released a revised and renamed Provider Self-Disclosure Protocol (SDP), now known as the “Health Care Fraud Self Disclosure “protocol. The OIG recognized that there are benefits to disclose potential fraud.

Overpayments 40

Overpayments Overpayment Fraud Medicare 40

MedTrainer

NOVEMBER 2, 2023

Most compliance officers possess a bachelor’s degree, often in healthcare administration, law, or a related field. Additionally, hands-on experience in healthcare or regulatory compliance provides a foundation for this role.

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

Health Care Law Brief

FEBRUARY 7, 2022

It is unclear, however, whether this new regulatory framework will ultimately benefit requestors. See e.g. , Advisory Opinion 21-10 as an example of the former, available at Advisory Opinion 21-10 | Office of Inspector General | Government Oversight | U.S. at 1368 (emphasis added). However, OIG’s sentiment may presume too much.

Fraud 52

Fraud Governance Compliance Regulatory Compliance 52

Health Law Advisor

JULY 14, 2023

EBG works closely, under attorney-client privilege, with organizations to conduct risk assessments and to identify recognized security practices that may bolster practical security and improve compliance defensibility.

Fraud 52

Fraud Regulatory Compliance Compliance Governance 52

Health Care Law Brief

JUNE 2, 2022

Therefore, a telehealth platform operating in all 50 states will, for example, need to comport with the laws governing corporate formation, provider licensure, scope of practice, and telehealth encounters in all 50 states. If so, how will patient fees be structured to comport with these restrictions? Provider Licenses.

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Healthcare IT Today

AUGUST 15, 2024

All because of one faulty update, mass amounts of flights were delayed and canceled, businesses such as banks or news broadcasts were forced to temporarily close, and most importantly, vital operations such as government agencies, emergency services, and healthcare organizations were also impacted. Look to SolarWinds.

US Department of Health and Human Services 131

US Department of Health and Human Services Ransomware Governance Hospitals 131

Health Care Law Brief

APRIL 11, 2022

Notwithstanding these streams of remuneration taking the form of cash equivalents and not being protected by an AKS regulatory safe harbor or by an exception to the Beneficiary Inducements CMP, the OIG still concluded that the Arrangement presented a minimal risk of fraud and abuse based on a totality of the underlying facts and circumstances.

Fraud 52

Fraud Medicare Medicare Compliance 52

MedTrainer

AUGUST 2, 2023

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Healthcare IT Today

JUNE 29, 2023

However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. Compliance Requirements for ASC Billing ASCs can face serious penalties for not complying with regulatory changes. Audits, fines, repayment demands, and government program suspensions are enforcement actions.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

Hall Render

NOVEMBER 25, 2024

Quality of Care and Quality of Life OIG identified that beyond the Requirements of Participation for Long Term Care Facilities in 42 CFR 483 , the failure to provide quality care and promote quality of life poses a risk of fraud and abuse for nursing facilities. Competency-Based Training.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

Health Care Law Brief

MARCH 8, 2022

Under both options, the Direct Contracting Entity’s (DCE) Participating Providers must have held at least 25% of the governing board voting rights. As such, an ACO may be required to meet other applicable State licensure requirements depending on the particular laws in a State and the discretion of a State’s regulatory agencies.

Medicare 52

Medicare Medicare Fraud Compliance 52

MedTrainer

JANUARY 16, 2025

MedTrainer Live: Upcoming NCQA Credentialing Changes Watch Now DEA Registrant Validation: In 2024, the DEA changed registrant validation to avoid fraud. The regulatory landscape for healthcare in 2025 emphasizes safety, privacy, and accessibility with added governance from the states.

Compliance 52

Compliance Regulatory Compliance COVID-19 HIPAA 52

Drug & Device Law

DECEMBER 29, 2023

2023) (federal government may unilaterally obtain dismissal of FCA claims, and calling the constitutionality of the FCA’s private enforcement mechanism into question) ( here ); Quishenberry v. 2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. In 2023, these include United States ex rel. Polansky v. 3d 239 (Cal.

FDA 105

FDA US Department of Health and Human Services COVID-19 COVID-19 Vaccine 105