Compliancy Group

JANUARY 17, 2024

The OIG Work Plan, sometimes referred to as “the Work Plan” or “the Plan,” is an essential tool in securing and maintaining healthcare regulatory compliance for patient safety, privacy, and quality care. OIG in healthcare , functioning as an arm of the U.S.

US Department of Health and Human Services 52

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

MedTrainer

AUGUST 30, 2023

Medicaid Managed Care. Some state Medicaid programs contract with managed care organizations to provide healthcare services to eligible beneficiaries. These plans follow managed care principles to control costs and improve care coordination for Medicaid recipients. Quality of Care Standards.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Compliancy Group

MAY 15, 2024

The healthcare landscape is fraught with complexities, and staying compliant involves understanding the OIG’s specific targets for hospital audits and crafting your OIG compliance program for your hospital with those in mind. Billing Integrity Hospitals must ensure that all billing practices adhere to federal laws and regulations.

Compliance 52

Compliance Hospitals Fraud Regulatory Compliance 52

Innovaare Compliance

JUNE 8, 2023

The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. These changes are significant and will have a major impact on Medicare and Medicaid plans. Plans will be required to provide more information about their quality improvement activities.

Medicaid 52

Medicaid Medicaid Medicare Medicare 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. and cybersecurity threats. .): Organizations using M.A.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 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

Verisys

FEBRUARY 14, 2024

Mitigating Provider Risk: Verisys’ solutions, such as FACIS® (Fraud Abuse Control Information System) , provide in-depth screening and continuous monitoring of healthcare professionals against the largest dataset of disciplinary actions and exclusions. How does Verisys help with healthcare compliance?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

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

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

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

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

Health Care Law Brief

JUNE 2, 2022

For example, the Department of Justice has aggressively pursued health care fraud claims against individuals and entities involved in non-compliant telehealth models. Does the state apply different standards, for example, to Medicaid encounters? If so, how will patient fees be structured to comport with these restrictions?

Public Health 52

Public Health Compliance COVID-19 Licensing 52

AIHC

MAY 30, 2024

Advancing RCM Operations Every year, more than five billion medical claims are processed by Payers in the United States for reimbursement, according to the Centers for Medicare & Medicaid Service, CMS.gov. Compliance and Risk Management : Fraud Detection : AI systems can identify unusual patterns that may indicate fraudulent activities.

Compliance 52

Compliance HIPAA Regulatory Compliance Medical Billing 52

Florida Health Care Law Firm

FEBRUARY 22, 2022

He has also had assets forfeited since these assets were acquired with money from his ill-gotten fraud scheme. That type of arrangement is equivalent to buying a referral, which is unlawful, violates antikickback statutes, and will result in false claims being filed with Medicare, Medicaid, Tricare, ChampVA, or others.

Telemedicine 40

Telemedicine Medicare Medicare Fraud 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

HIT Consultant

DECEMBER 6, 2022

As within many areas of health care, however, expansion and innovation contributed to a higher risk of fraud and resulted in an increase in enforcement activity. Telemental health providers were not immune to this activity in 2022, and providers should prioritize regulatory compliance as the industry looks ahead to 2023. “As

Compliance 98

Compliance COVID-19 Medicaid Medicaid 98

Health Care Law Brief

MARCH 8, 2022

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, which will begin January 1, 2023, and replace the Global and Professional Direct Contracting (GPDC) Model.

Medicare 52

Medicare Medicare Fraud Compliance 52