Questions for Compliance Officers Preparing for ICD-10
Time is running out before the changeover to ICD-10 on October 1st 2015. Although it is the responsibility of program…
Tips For Managing Medicare Claims Appeals
Managing Medicare claims appeals continues to be a heavy burden for providers. In light of the Office of Medicare Health…
12 Rules for Conducting Successful Compliance Investigations
Conducting successful internal investigations depends on following the proper guidelines. It is too easy for individuals inexperienced in conducting investigations…
Alternative Options for Staffing a Compliance Program
Compliance Officers must manage staffing needs against a growing list of duties and responsibilities. Finding and hiring highly qualified staff…
HIPAA Privacy Breaches Increasing At A Rapid Rate
The Anthem data breach last February served as a wakeup call to many Privacy, Security, and Compliance Officers since it…
Tips For Evidencing Compliance Training Effectiveness
The compliance officer’s responsibilities include developing, coordinating and participating in a multifaceted training program that focuses on the elements of…
OIG Finds Ineffective Controls In The Federal Marketplace To Verify Eligibility
In a recent blog I addressed a Government Accountability Office (GAO) report that described their ability to enroll fraudulently in…
“60 Day” Court Ruling Shocks Providers And Rings A Warning Bell To Compliance Officers
Tips and Suggestions from Experts The Affordable Care Act (ACA) mandated reporting and returning of overpayments within 60 days of…
CMS Establishes New Rules For Medicare Shared Savings Programs
The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule addressing changes to the Medicare Shared Savings…
OIG Finds That Barred Providers Are Still Billing Medicaid
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported that hundreds of Medicaid providers that…
Continued Questions About GSA Debarment Screening
Federal agencies can exclude (suspend or debar) businesses or individuals from receiving government contracts or assistance for various reasons. The…
CMS Proposes New Rule To Reduce Stark Law Burdens And Confusion
Recently, the Fourth Circuit Court of Appeals decided against the Tuomey Healthcare System in a case that has resulted in…