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Read the latest news that impacts the healthcare compliance profession.
Effective approaches to stakeholder pushback
At the core of every successful organization is a robust compliance program that not only ensures adherence to applicable standards but also fosters an ethical...
CARES Act appeals: Key steps in addressing denials and repayments
With the onset of the COVID-19 pandemic, Congress initiated several programs to help businesses weather the difficult economic conditions. The Coronavirus Aid, Relief, and Economic...
It is de-identified, or is it?
How many of us have heard one of our stakeholders assert that their data set is de-identified? As privacy compliance professionals, we are often tasked...
Discharge planning conditions of participation: Key to safe transitions and compliance risk
To safeguard Medicare and Medicaid beneficiaries’ health and safety, the Centers for Medicare & Medicaid Services (CMS) develops and publishes Conditions of Participation (CoPs) and...
Ice cream, passwords, and building a culture of compliance
One challenge for any compliance program is developing compliance messaging that will be effective across an employee population that has diverse expertise, technical knowledge, experience,...
The roles of a compliance officer: A fresh view of the profession
Over the past three decades in my career as a compliance adviser and advocate for healthcare organizations, I have been asked the same question countless...
A whole new world: How to navigate designing and implementing a fresh compliance program
If you find yourself in a situation where you need to develop a compliance program, ask yourself, “What do I need to do, and where...
Triple check process: An effective quality assurance tool for skilled nursing facilities
In June 2023, the Centers for Medicare & Medicaid Services (CMS) launched a skilled nursing facility (SNF) 5-Claim Probe and Educate Review program. This program...
CMS implements new regulations to restrict Medicare Advantage organizations
As the number of Medicare enrollees choosing Medicare Advantage (MA) over traditional Medicare has steadily increased over the past decade and a half, healthcare providers...
A practical guide for utilizing psychotherapy notes in your EHR
The prevalence of mental health conditions and the need for adequate treatment has long been on the rise in the United States. Early in the...