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Healthcare Regulatory Compliance Services
Today’s health care compliance and regulatory environment is among the most complex in our nation. Health care organizations need to…
Systems Reviews versus Transaction Reviews — A Closer Look at a New Era of Mandatory Compliance
A New Era of Mandatory Healthcare Compliance Programs Compliance programs initially were voluntary in the healthcare industry. Eventually managed care…
Systems Reviews versus Transaction Reviews in CIAs: Takeaways for Compliance Officers
Most compliance officers do not have to face the scrutiny and challenges of operating a compliance program under a Corporate…
CMS RAC Audits: Complex Review Issues
Although the Centers for Medicare and Medicaid Services (CMS) implemented the Recovery Audit Contractor (RAC) as a permanent program over a year…
CIA Compliance And Independent Review Organizations: Where to Start in the Selection Process?
The heightened focus on health care fraud, waste, and abuse continues to evolve and steadily climb given political and fiscal…
More Health Care Executive and Board Accountability on the Way
Under the “Responsible Corporate Officer” doctrine, officers are subject to both criminal and civil liability for corporate violations of statutes…
Sanction Screening OIG High Risk Priority
Given the high level of enforcement emphasis on this issue, hospitals need to make it a high priority to screen…
Advance Beneficiary Notice Form: CMS Announces New ABN Modifiers
In 2009, the Centers for Medicare & Medicaid Services (CMS) implemented the use of the revised Advance Beneficiary Notice Form…
GAO Yellow Book Standards and Independent Review Organizations
The heightened focus on health care fraud, waste, and abuse at both the Federal and State levels in recent years…
How Can CEOs and Board Members Keep Score on Compliance Risks?
The U.S. Sentencing Commission and the Office of Inspector General (OIG) gave health care institutions a clear guide to effective…
Clarifying Sanction Screening: OIG LEIE Versus GSA EPLS
For over a decade, the OIG has been issuing “voluntary” compliance program guidance for the various health care sectors. In…
Managing Risks When Implementing the New EHR Disclosure Accounting Requirements of ARRA
The American Recovery and Reinvestment Act of 2009 (ARRA) was signed into law on February 17, 2009, a critical measure to stimulate…