General Compliance

Why payers can’t ignore the interoperability rules and should comply sooner rather than later

Catherine Short speaks with Dr. Chris Hobson, Chief Medical Officer for Orion Health. The topic of today’s program is “Why payers can’t ignore the interoperability rules and should comply sooner rather than later.” The Interoperability and Patient Access final rule approved by CMS and ONC is intended to advance patient participation through access to their health information and to drive advanced interoperability and innovation across the U.S. These rules will have significant impact on payer organizations who are currently facing unprecedented times.

Steering Clear of Legal Liability

Catherine Short speaks with Trey Scott, Coordinating Attorney for Kennedy, Attorneys & Counselors at Law located in Dallas, TX. The topic of today’s program is “Steering Clear of Legal Liability.” The discussion will help the audience navigate the choppy waters of potential legal actions that often arise in the world of healthcare. We will start with a basic overview of the typical steps leading up to the filing of a lawsuit. Listeners will also learn how to prepare for potential future litigation, and how to avoid simple mistakes that can later prove costly in a lawsuit.

Billing for Chronic Care Management: What Are the Problematic Issues?

Catherine Short speaks with Markus P. Cicka, J.D., LL.M. (Health Law), owner of the Law Office of Markus P. Cicka, LLC, a law firm based in Saint Louis, Missouri, about the topic of “Billing for Chronic Care Management: What Are the Problematic Issues?” We will discuss what is chronic care management, have an understanding of who exactly can bill for providing chronic care management services, and discover what are recent chronic care management billing issues that have been flagged by the OIG. 

Combat COVID-19 in the Healthcare Setting with Hand Hygiene Compliance

Combat COVID-19 in the Healthcare Setting with Hand Hygiene Compliance

The importance of hand hygiene compliance has never been greater as it’s a vital part of the U.S. response to the COVID-19 pandemic. All individuals are instructed to wear a mask, practice social distancing and excercise frequent hand washing. In medical offices and hospitals hand hygiene takes on even greater significance. Practicing hand hygiene, which includes the use of alcohol-based hand rub (ABHR) or handwashing, is a simple yet effective way to prevent the spread of pathogens and infections in healthcare settings.

The Biggest Recent Health Care Scams & How to Avoid Being a Target

Catherine Short speaks with Stephen Bittinger, Health Care Reimbursement Partner at K&L Gates, about the topic of “The Biggest Recent Health Care Scams & How to Avoid Being a Target.” We will be learning the mechanics of some of the largest recent health care fraud scams, how many providers became victims of these scams, and how to avoid these types of risks in the future. We will study the mechanics of health care fraud scams and the impact on providers caught in them, discover how to identify health care fraud scams and discuss resources for providers to educate themselves, and learn from other providers’ mistakes on how to avoid health care fraud scams and decrease risk to revenue cycle.

Updated DOJ Guidance and 6 Takeaways for Compliance Officers

Updated DOJ Guidance and 6 Takeaways for Compliance Officers

On June 1, 2020, the Department of Justice’s (DOJ) Criminal Division released revisions to its Evaluation of Corporate Compliance Programs guidance for use with federal prosecutors when investigating corporations for criminal misconduct. This guidance updates the 2019 version that was covered in a previous blog post and provides insight into the DOJ’s expectations for corporate compliance programs. 

CMS Compliance 2020

Understand CMS Changes to Compliance Training for Healthcare Providers under Medicare Advantage and Part D

Establishing and maintaining a well-designed compliance program is key to preventing, detecting, and mitigating noncompliance. The seven elements of an effective compliance program outlined in the Federal Sentencing Guidelines, sets the framework but there are additional requirements that need to be integrated into the compliance program in order to be effective.