Healthcare Compliance

fraud waste abuse healthcare compliance

FWA in Healthcare: How to Respond Appropriately to Detected Offenses

Fraud, Waste, and Abuse (FWA) can have serious implications for the healthcare industry, affecting patient care, financial stability, and organizational integrity. Detecting and responding to FWA offenses promptly and appropriately is essential to protect the well-being of patients, uphold ethical standards, and maintain regulatory compliance.

Exclusion Screening Requirements for Healthcare Entities: Ensuring Compliance and Protecting Your Organization

Exclusion Screening Requirements for Healthcare Entities: Ensuring Compliance and Protecting Your Organization

One crucial aspect healthcare entities must prioritize in the ever-evolving landscape of healthcare regulations is exclusion screening, which is the process of checking individuals and entities against various exclusion lists to ensure compliance with federal and state regulations. Failing to comply with these requirements can have serious consequences for your organization. Read on to explore the importance of exclusion screening, its benefits, and how partnering with the right experts can help you navigate this critical aspect of healthcare compliance.

FTC and Poaching of PHI

The Increasing Role of the FTC in the Poaching of PHI – A Discussion of Better Help, GoodRx & Flo: Audio Version of the Webinar

Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX will be presenting this informative webinar. Cybersecurity risk management and the potential for enforcement actions is not diminishing. An area of increasing interest by the Federal Trade Commission, the United States Department of Justice, and Congress is third parties taking sensitive data (especially by social media and search engine giants), including protected health information, without obtaining affirmative patient/consumer consent and benefiting financially. The U. S. Department of Health and Human Services, the agency tasked with enforcing HIPAA, also plays a critical role. The purpose of this presentation is to address different federal government initiatives, recent enforcement actions and incidents, and risk mitigation.

Evolution of Price Transparency and How to Stay Ahead of CMS Requirements

1st Talk Compliance features guest Govi Goyal, President, Financial Services, at Panacea Healthcare Solutions, on the topic of Evolution of Price Transparency and How to Stay Ahead of CMS Requirements. Govi joins our host Catherine Short to discuss how the new CMS Price Transparency Rule and No Surprises Act are closely related. By providing Good Faith Estimates for healthcare services, hospitals can comply with both regulations. This helps patients understand their expected costs upfront and avoid surprise medical bills. Panacea’s CMS Price Transparency and Hospital Zero-Base Pricing software solutions can assist hospitals in providing accurate Good Faith Estimates to their patients and stay compliant with the latest regulations. 

A Harassment-Free Workplace vs the Right to Engage in Concerted Activity

1st Talk Compliance features guest Lauren Moak Russell, Counsel at Young Conaway Stargatt & Taylor, LLP in Wilmington, Delaware, on the topic of “A Harassment-Free Workplace vs the Right to Engage in Concerted Activity.” Lauren joins our host Catherine Short to discuss how the National Labor Relations Board under the Biden Administration has expressed a renewed interest in expanding its influence into non-unionized work forces. This includes reviewing and–in the right circumstances challenging–employers’ use of workplace civility, confidentiality, and anti-harassment policies. Listen as we discuss what you need to know to safely navigate the National Labor Relations Act while ensuring that your employees enjoy a safe and respectful work environment.

First Healthcare Compliance to Showcase Compliance Solutions at the 27th Annual Compliance Institute in Anaheim, California

First Healthcare Compliance to Showcase Compliance Solutions at the 27th Annual Compliance Institute in Anaheim, California

First Healthcare Compliance, a division of Panacea Healthcare Solutions will showcase a range of software and learning solutions at both the Healthcare Compliance Association’s (HCCA) 27th Annual Compliance Institute, to be held April 23-26 at the Anaheim Convention Center in Anaheim, California, and the Virtual Conference, April 24 – 26.

A Practical Approach to The Safe Harbor Law

1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of A Practical Approach to The Safe Harbor Law. Ray joins our host Catherine Short to discuss how HIPAA data breach penalties typically get measured in millions of dollars, even following an organization implementing NIST cybersecurity framework measures. However, with the new HIPAA Safe Harbor Law, signed in January 2021, HHS and OCR may consider some penalty mitigation. It is important to understand that the Safe Harbor Law, while offering substantial protection, does not provide a true safe harbor and only offers some protection. This episode will examine what the established security practices for healthcare are, and how to pivot your organization’s security profile to mitigate breach penalties if an event occurs.

The Risk of Data Sharing

1st Talk Compliance features guest Iliana L. Peters, Shareholder at Polsinelli PC, on the topic of The Risk of Data Sharing. Iliana joins our host Catherine Short to discuss how these days, health data is an incredibly valuable commodity. Companies of all types should consider the legal risk with data valuation, data ownership, and data sharing agreements. In this episode, we will be discussing the scope and breadth of data sharing projects in development in the health care sector, examine contractual, state, federal, and international legal obligations for data privacy and security for such projects, and discuss issues related to data ownership that may also be part of such projects.

DMEPOS – In Compliance with CMS

1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., on the topic “DMEPOS – In Compliance with CMS.” Rachel joins our host Catherine Short to discuss special payment rules associated with durable medical equipment, prosthetics, orthotics and supplies. DMEPOS products must meet quality standards, suppliers need to be accepted by Medicare to participate, similar to providers, and are subject to fraud, waste, and abuse laws. This episode will provide an overview of participation and quality requirements, relay the latest compliance and requirements updates, and discuss the consequences of non-compliance, as well as submitting false and fraudulent claims.