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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. 

Catherine Short
Abuse, AKS, Anti-Kickback Statute, Audits, Billing, Company Culture, compliance program, Compliance Tips, Compliance Training, Employee Training, Employee Zone, Ethics, Fraud, Fraud, Waste, and Abuse, Healthcare Compliance, Healthcare Compliance Software, Healthcare Law, Medicaid, medical records, Medicare, Medicare Rules, mobile security, physician self-referral law, Podcasts, Policy Management, Risk Management, Security, self-disclosure, Stark Law, Training, Vendor Zone, Waste, Whistleblower, Wrongdoing
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Employee Snooping & Insider Threats

1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of “Employee Snooping & Insider Threats.” Ray joins our host Catherine Short to discuss snooping and insider threats and why user monitoring and ePHI access strategies are vital to the security of sensitive patient information and data protection. With so much attention and money surrounding cybersecurity in the healthcare industry, malicious employees may decide to purposefully disclose patient information. Since employees and contractors may have knowledge of your network setup, vulnerabilities, and access codes, snooping employees with malicious intent hold the key to exposing your organization to a series of unwanted risks and threats. Listen as we identify signs of unauthorized access, provide guidelines to prevent snooping, and offer procedures to detect insider threats.

Catherine Short
Company Culture, compliance program, Compliance Tips, Compliance Training, Cybersecurity, Data Collection, Data Privacy, Data Security, Employee Training, Employee Zone, Ethics, Healthcare Compliance, Healthcare Compliance Software, Healthcare Law, HIPAA, HIPAA Privacy Rule, HIPAA Zone, HITECH, medical identity theft, medical records, mobile security, PHI, Podcasts, Privacy, Protected health information, Risk Management, Security, security breach, Security Zone, social media, Training, Whistleblower, Wrongdoing
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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.

Catherine Short
Business Associate, Business Associate Agreements, Company Culture, compliance program, Compliance Tips, Compliance Training, Data Privacy, Employee Training, Employee Zone, Employment Law, Ethics, Fair Labor Standards Act, Healthcare Compliance, Healthcare Law, Human Resources, Podcasts, Privacy, Protected health information, Security, security breach, Security Zone, social media, Training, Uniformed Services Employment and Reemployment Rights Act, USERRA, Whistleblower, Wrongdoing
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DMEPOS Webinar

DMEPOS – CMS Compliance and Requirements Updates: Audio Version of the Webinar

Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely subject for us. Durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) includes an “entity or individual, including a physician or a Part A provider, which sells or rents Part B covered items to Medicare beneficiaries.” There are special payment rules associated with DMEPOS. DMEPOS products have to meet quality standards, DMEPOS suppliers need to be accepted by Medicare to participate (similar to providers), and are subject to fraud, waste, and abuse laws. The purpose of this webinar to provide an overview of participation and quality requirements, relay the latest compliance and requirements updates, and address False Claims Act cases involving DMEPOS companies.

Catherine Short
Abuse, Billing, Business Associate, CMS, Company Culture, compliance program, Compliance Tips, DOJ, effective compliance program, Employee Training, Employee Zone, Ethics, False Claim Act, false claims act, FCA, Fraud, Fraud, Waste, and Abuse, General Compliance, Human Resources, Medicare, Medicare Rules, Podcasts, Resource Allocation, Risk Management, self-disclosure, Stark Law, Waste, Wrongdoing
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Fraud, Healthcare, COVID-19 and the False Claims Act

Catherine Short speaks with Shauna Itri, Partner at Seeger Weiss LLP on the topic of “Fraud, Healthcare, COVID-19 and the False Claims Act.” A whistleblower or qui tam action can provide financial rewards to individuals who have information that a company/individual has committed fraud. The primary statutes under which this relief may be sought are the federal and state False Claims Acts (“FCAs”). In addition to the FCAs, there are other statutes which apply to tax fraud, securities fraud, and in California, fraud on private insurance companies. This episode will provide an overview of the False Claims Acts, the knowledge and skills to be able to recognize a potential whistleblower case, and understand the unique procedures utilized in filing whistleblower cases/tips. We will also delve into recent trends in cases brought (or that could be brought) under the False Claims Act including cases involving mined data and potential fraud related to COVID-19.

Catherine Short
False Claim Act, false claims act, FCA, Podcasts, Security, Whistleblower, Wrongdoing
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CANDOR webinar

Medical Error, CANDOR/candor, and Patient Advocacy

First Healthcare Compliance hosts Kathleen W. McNicholas, MD, JD, CHC, CCEP, Consultant and Patient Advocate with Medical Legal Patient Advocacy Inc., for an interactive discussion on “Medical Error, CANDOR/candor, and Patient Advocacy.” Dr. McNicholas will review medical error and provide an approach to harmed patients. The CANDOR program of Communication and Optimal Resolution will be explained. CANDOR is well established and has been successfully adopted by many medical centers. With CANDOR in place, patients may benefit from the use of the principles and the help of a board-certified patient advocate.

Catherine Short
Company Culture, Education, Employee Training, Ethics, Patient Advocacy, Patient Safety, Patient Satisfaction, Physician-patient Relationship, Podcasts, Training, Uncategorized, Wrongdoing
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Performance Improvement Plan

Is Your Compliance Program Effective?

Having a compliance program in place is a start but having an effective compliance program is the goal. Proactively assessing the effectiveness of one’s own compliance program is better than…
First Healthcare Compliance Staff
1st Healthcare Compliance, Abuse, ACA, Anti-Kickback Statute, Audit Zone, Blog, Breach, compliance program, Corporate Integrity Agreement, Dashboard Zone, DOJ, effective compliance program, Employee Zone, FCA, Fraud, Healthcare, HIPAA, HIPAA Zone, ICD-10, Individual Accountability, LEIE, OSHA, OSHA Zone, physician self-referral law, Quarterly Zone, Stark Law, Uncategorized, Whistleblower, Wrongdoing
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Beware of Individual Liability: Yates Memo

On September 9, 2015, the Department of Justice (DOJ) Deputy Attorney General Sally Yates released a policy memorandum, titled “Individual Accountability for Corporate Wrongdoing,” also known as the “Yates Memo.”…
Sheba Vine, JD, CPCO
1st Healthcare Compliance, Abuse, Anti-Kickback Statute, Audit Zone, Blog, Corporate Integrity Agreement, DOJ, Fraud, Individual Accountability, OIG, Overutilizaton, physician self-referral law, Quarterly Zone, Uncategorized, Waste, Whistleblower, Wrongdoing, Yates Memo
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