Corporate Compliance

Corporate Compliance Articles by Topic: Hospital Compliance

Other Issuances: HHS posts regulatory review plan

  • Medicare Insider, Issue 23, June 7, 2011

    HHS has posted its plan for retrospective review of existing regulations.

HHS plans to review existing rules

  • Compliance Monitor, Issue 22, June 1, 2011

    On Thursday, May 26, the Department of Health and Human Services (HHS) announced its plans to...

Large patient information breach list reaches 265

  • Compliance Monitor, Issue 18, May 4, 2011

    The number of entities reporting breaches of unsecured PHI affecting at least 500 individuals to...

Tip: Incorporate your compliance program into your performance plan

  • Compliance Monitor, Issue 18, May 4, 2011

    When evaluating the performance of managers and supervisors, factor in adherence to the elements of...

Dallas hospital files Medicare fraud suit against a hostile takeover bidder

  • Compliance Monitor, Issue 16, April 20, 2011

    Dallas-based Tenet Healthcare Corp. filed a Medicare fraud lawsuit that accuses Community Health...

Tip: Review your compliance program

  • Compliance Monitor, Issue 16, April 20, 2011

    An effective compliance program should incorporate periodic (at least annual) reviews to determine...

Regulations: HHS seeks input on regulatory review

  • Medicare Insider, Issue 16, April 19, 2011

    On April 13, HHS published in the Federal Register a request for information regarding its...

Regulations: Comment on the ACO/waiver rulemaking

  • Medicare Insider, Issue 15, April 12, 2011

    CMS and the OIG have published rulemaking on accountable care organizations (ACO) and applicable...

Los Angeles woman pleads guilty to participating in a $6.2 million Medicare fraud scheme

  • Compliance Monitor, Issue 14, April 6, 2011

    Carolyn Ann Vasquez of Los Angeles pleaded guilty to using fraudulent medical clinics and the...

CMS explains new provider enrollment provisions

  • Compliance Monitor, Issue 14, April 6, 2011

    CMS has issued MLN Matters Article MM7350 to explain how the new provider enrollment provisions...

CMS published screening requirements final rule and FAQs

  • Compliance Monitor, Issue 13, March 30, 2011

    CMS has issued a final rule to implement provisions of the Patient Protection and Affordable Care...

Regulations: CMS posts 2011 Medicare enrollment application fee

  • Medicare Insider, Issue 13, March 29, 2011

    On March 23, CMS published in the Federal Register a notice to announce the $505 calendar year...

MA hospital settles billing violations using the self-disclosure protocol

  • Compliance Monitor, Issue 12, March 23, 2011

    Saints Medical Center in Lowell, MA, will pay $579,000 to settle alleged Medicare billing...

Tip: Use the New York model to develop a compliance program

  • Compliance Monitor, Issue 12, March 23, 2011

    New York has a mandatory compliance program model already in place, and the federal government is...

Health Net, Inc., involved in potential HIPAA breach affecting 1.9 million patients

  • Compliance Monitor, Issue 11, March 16, 2011

    For the second time in less than a year, health insurance giant Health Net, Inc., is involved in a...

Sen. Grassley introduces new Medicare and Medicaid fraud legislation

  • Compliance Monitor, Issue 10, March 9, 2011

    Senator Chuck Grassley introduced legislation to build on key reforms to fight fraud in Medicare...

Las Vegas woman pleads guilty to acting as the straw owner of fraudulent DME company

  • Compliance Monitor, Issue 10, March 9, 2011

    Jummal Joy Ibrahim, 55, of Las Vegas pleaded guilty to falsely representing to Medicare that she...

Infusion clinic owner, physician sentenced to prison for $2.3 million fraud scheme

  • Compliance Monitor, Issue 10, March 9, 2011

    An owner and a physician associated with a Detroit-area infusion therapy clinic will serve 120...

Tip: Get support from the top

  • Compliance Monitor, Issue 10, March 9, 2011

    One crucial element of a good compliance program is having a supportive board and senior management.

Regulations: CMS publishes screening requirements final rule

  • Medicare Update for Physician Services, Issue 3, March 3, 2011

    On February 2, CMS published in the Federal Register a final rule to implement provisions of the...

MGH pays $1M and enters into a CAP to settle potential HIPAA violations

  • Compliance Monitor, Issue 9, March 2, 2011

    The General Hospital Corporation and Massachusetts General Physicians Organization, Inc., (Mass...

HHS imposes first CMP for a HIPAA violation, Cignet will pay $4.3M

  • Compliance Monitor, Issue 9, March 2, 2011

    The HHS Office for Civil Rights (OCR) imposed a civil money penalty (CMP) of $4.3 million to Cignet...

Medicare Fraud Strike Force charges 111 in the country's largest healthcare fraud takedown

  • Compliance Monitor, Issue 8, February 23, 2011

    The Medicare Fraud Strike Force charged 111 defendants in nine cities for their alleged...

Twenty FL residents charged with participation in $200 million Medicare fraud scheme

  • Compliance Monitor, Issue 8, February 23, 2011

    Twenty southern Florida residents were indicted for various healthcare fraud, kickback, and money...

DME office manager pleads guilty to Medicare fraud

  • Compliance Monitor, Issue 8, February 23, 2011

    The office manager of a Los Angeles durable medical equipment (DME) company pleaded guilty today to...

New York City Health and Hospitals Corp. privacy breach affects 1.7 million

  • Compliance Monitor, Issue 7, February 16, 2011

    The New York City Health and Hospitals Corporation (HHC) must notify 1.7 million patients, hospital...

Medical assistant sentenced to 3 years in prison for Medicare fraud scheme

  • Compliance Monitor, Issue 7, February 16, 2011

    Guy Ross, 51, a Detroit-area medical assistant, will serve 36 months in prison and pay $472,000 in...

Regulations: CMS publishes screening requirements final rule

  • Medicare Insider, Issue 6, February 8, 2011

    CMS published in the Federal Register a final rule to implement provisions of the Patient...

Regulations: CMS posts IPF PPS proposed rule, screening requirements final rule

  • Medicare Insider, Issue 5, February 1, 2011

    CMS has issued a display copy of a final rule to implement provisions of the Patient Protection...

Healthcare fraud prevention and enforcement efforts recover record $4 billion

  • Compliance Monitor, Issue 4, January 26, 2011

    The government’s healthcare fraud and abuse efforts netted more than $4 billion in fiscal...

Medical supply company owner sentenced to three years for Part D fraud

  • Compliance Monitor, Issue 3, January 19, 2011

    Renier Vicente Rodriguez Fleitas, 60, of Miami-Dade County, will serve 37 months after pleading...

Behavioral counseling company owner sentenced to prison for fraud scheme

  • Compliance Monitor, Issue 3, January 19, 2011

    Edward Birts, 51, will serve more than five years in federal prison without parole and pay more...

Staff members at UMC Tucson fired for inappropriately accessing medical records

  • Compliance Monitor, Issue 3, January 19, 2011

    University Medical Center in Tucson, AZ, fired three clinical support staff members and a...

DME company owner, physician sentenced for Baton Rouge-area fraud scheme

  • Compliance Monitor, Issue 2, January 12, 2011

    Dahlia V. Kirkpatrick, MD, and Emmanuel M. Komandu, the owner and operator of Alpha Medical...

Detroit Medical Center pays $30 million to settle False Claims Act allegations

  • Compliance Monitor, Issue 1, January 5, 2011

    Detroit Medical Center agreed to pay the United States $30 million to settle allegations that it...

Federal agencies seek input on anti-kickback statute and EMTALA rules

  • Compliance Monitor, Issue 1, January 5, 2011

    In two separate Federal Register issues, the Office of Inspector General (OIG) and CMS solicited...

Medical clinic owner and VP sentenced to prison for $23 million Medicare fraud scheme

  • Compliance Monitor, Issue 48, December 22, 2010

    Bernice Brown, 56, the owner of a Detroit-area physical therapy clinic, and Daniel Smorynski, 63...

Detroit-area doctor sentenced to 36 months in prison for Medicare fraud scheme

  • Compliance Monitor, Issue 48, December 22, 2010

    Alan Silber, MD, will serve 36 months in prison for participating in a scheme to defraud the...

Q&A: Taping intake and output sheets outside of patient rooms

  • Compliance Monitor, Issue 48, December 22, 2010

    Q: Our nursing staff continues to tape patient intake and output sheets outside of patient...

Former hospital CEO convicted of six counts related to Medicaid fraud

  • Compliance Monitor, Issue 47, December 15, 2010

    Ken B. Beverly, former CEO of Thomasville, GA–based Archbold Memorial Hospital, was convicted...

Tip: Restrict PHI disclosures

  • Compliance Monitor, Issue 47, December 15, 2010

    The HIPAA Privacy Rule requires that access to and disclosure of protected health information (PHI...

St. John's hospitals pay $2.2 million to settle false claims allegations

  • Compliance Monitor, Issue 46, December 8, 2010

    St. John’s Mercy Health System and St. John’s Health System, Inc., agreed to pay $2.2...

Q&A: What is fraud?

  • Compliance Monitor, Issue 46, December 8, 2010

    Q: What is fraud?

Tip: Support your compliance program with a compliance committee

  • Compliance Monitor, Issue 45, December 1, 2010

    Creating and facilitating a compliance program is no easy task, so the responsibilities should not...

HIV clinic operator sentenced to 57 months in prison for Medicare fraud

  • Compliance Monitor, Issue 44, November 24, 2010

    U.S. District Judge Adalberto Jordan sentenced Jose Garcia, 55, to 57 months in prison for...

CA hospital settles Medicare fraud case for $5.1M

  • Compliance Monitor, Issue 42, November 10, 2010

    Simi Valley (CA) Hospital paid the United States $5.1 million to resolve allegations that its...

Christ Hospital enters five-year CIA to resolve anti-kickback case

  • Compliance Monitor, Issue 41, November 3, 2010

    The Christ Hospital (TCH) of Cincinnati, OH, and the Office of Inspector General (OIG) entered into...

Patient recruiter known as 'Red, White, & Blue Man' sentenced to 21 months in prison

  • Compliance Monitor, Issue 41, November 3, 2010

    James Roland Fuquay, 49, will serve 21 months in prison and pay $557,000 for his participation in a...

Patient recruiter pleads guilty to role in $5.2 million home healthcare scheme

  • Compliance Monitor, Issue 41, November 3, 2010

    A Houston-based patient recruiter pleaded guilty in connection with a $5.2 million Medicare fraud...

Tip: Consider the compliance department's role in your facility's RAC team

  • Compliance Monitor, Issue 41, November 3, 2010

    If your facility has a robust compliance department, the recovery audit contractor (RAC) team may...

House passes Medicare anti-fraud bill

  • Compliance Monitor, Issue 36, September 29, 2010

    The U.S. House of Representatives passed a bill that expands the authority of the HHS Office of...

CA hospital to pay US $5.25 million for "turbocharging"

  • Compliance Monitor, Issue 34, September 1, 2010

    A Santa Monica, CA hospital will pay the United States $5.25 million to resolve allegations that...

Survey: Tax-exempt status

  • Compliance Monitor, Issue 34, September 1, 2010

    Survey: Tax-exempt status

Medicare Fraud Strike Force arrests 94 in largest Medicare fraud bust

  • Compliance Monitor, Issue 28, July 21, 2010

    The Medicare Fraud Strike Force charged 94 people for their alleged participation in various...

Detroit physical therapist and medical assistant plead guilty to Medicare fraud

  • Compliance Monitor, Issue 28, July 21, 2010

    Two Detroit citizens pleaded guilty in U.S. District Court for their roles in a Medicare home...

Heart device manufacturer and two hospitals to pay nearly $4M in False Claims suit

  • Compliance Monitor, Issue 22, June 9, 2010

    A Minnesota-based heart device manufacturer, St. Jude Medical Inc., and two hospitals will pay...

Hospital group and former member to pay $108 million for Medicare and Medicaid fraud

  • Compliance Monitor, Issue 20, May 26, 2010

    The Health Alliance of Greater Cincinnati and one of its former member hospitals, The Christ...

Nine hospitals settle allegations of falsely billing kyphoplasty procedures

  • Compliance Monitor, Issue 19, May 19, 2010

    Nine hospitals in seven states will pay the United States more than $9.4 million combined to...

Seven tips to keep your coding compliance program fresh

  • Strategies for Health Care Compliance, Issue 5, May 1, 2010

    Just because your coding compliance program is in place doesn’t mean it’s doing its job...

Strategies for Health Care Compliance, May 2010

  • Strategies for Health Care Compliance, Issue 5, May 1, 2010

    In this issue of SHCC, you’ll read about steps you can take to comply with the Red Flags Rule...

Survey: Compliance teammates

  • Compliance Monitor, Issue 14, April 14, 2010

    Survey: Compliance teammates

Tip: Adhere to U.S. sentencing guidelines

  • Compliance Monitor, Issue 13, April 7, 2010

    Tip: Adhere to U.S. sentencing guidelines

Other Issuances: CMS delays CAH supervision enforcement, RAC updates audit issues, and more

  • Medicare Insider, Issue 12, March 23, 2010

    On March 15, CMS issued a notice to Congress that it had instructed its contractors not to evaluate...

NY hospital pays $2.9M to resolve false claims allegations

  • Compliance Monitor, Issue 9, March 3, 2010

    Brookhaven Memorial Hospital Medical Center in Long Island, NY, will pay $2.92 million to resolve...

Regulations: No issuances this week

  • Medicare Insider, Issue 5, February 2, 2010

    CMS issued no significant regulations affecting hospital billing this week.

Anesthesiologist falsifies medical research, faces fines and jail time

  • Compliance Monitor, Issue 3, January 20, 2010

    A federal judge charged Scott Reuben, chief of acute pain at Bay State Hospital in Springfield, MA...

Q&A: Faxing patients' medical records

  • Compliance Monitor, Issue 3, January 20, 2010

    Q: Is it permissible to fax patient medical records between physicians without patient...

MN hospital to pay $846,000 for improper admissions

  • Compliance Monitor, Issue 1, January 6, 2010

    Wheaton Community Hospital and Stanley Gallagher, MD, (collectively WCH) agreed to pay $846,000 to...

Trinity Health agrees to pay $205,000 to settle false claims case

  • Compliance Monitor, Issue 52, December 30, 2009

    Trinity Health agreed to pay $205,000 to settle claims that its subsidiary hospital, St. Joseph...

Tip: Support your compliance program

  • Compliance Monitor, Issue 50, December 16, 2009

    Creating and facilitating a compliance program is no easy task, so the responsibilities should not...

Iowa hospital pays U.S. $400,000 in False Claims Act settlement

  • Compliance Monitor, Issue 49, December 9, 2009

    Mercy Medical Center in Sioux City, IA, will pay $400,000 to settle allegations of inflating...

Texas Hospital group pays U.S. $27.5 million in false claims settlement

  • Compliance Monitor, Issue 44, November 4, 2009

    A Texas hospital group will pay the United States $27.5 million to resolve allegations that it...

Note: CMS issues 2010 final rule for ambulatory surgery centers and most hospital outpatient departments

  • Medicare Insider, Issue 45, November 3, 2009

    CMS has released a display copy of the outpatient prospective payment system (OPPS) final rule for...

Pfizer to pay $2.3 billion for largest healthcare fraud settlement in history

  • Compliance Monitor, Issue 36, September 9, 2009

    Pharmaceutical giant Pfizer Inc. and its subsidiary Pharmacia & Upjohn Company Inc. will pay...

IA medical center settles false claims case for $4.5 million

  • Compliance Monitor, Issue 35, September 2, 2009

    Covenant Medical Center in Waterloo, IA, agreed to pay $4.5 million to settle claims that it had...

Tip: Designate a compliance committee

  • Compliance Monitor, Issue 32, August 12, 2009

    One way to strengthen your compliance department is to designate a compliance committee. A...

Tip: Report non-compliance promptly

  • Compliance Monitor, Issue 26, July 1, 2009

    If the compliance officer or committee discovers evidence of misconduct or noncompliance and has...

Former CA hospital executive pleads guilty to 'Skid Row' fraud scheme

  • Compliance Monitor, Issue 25, June 24, 2009

    Robert Bourseau, former board member and co-owner of City of Angels Medical Center in Los Angeles...

WV physician seeks new fraud trial

  • Compliance Monitor, Issue 22, June 3, 2009

    John Sharp M.D., of Marlington, WV, will appear before U.S. District Judge Irene Keeley to request...

Obama signs fraud bill into law

  • Compliance Monitor, Issue 21, May 27, 2009

    On May 20, President Barack Obama signed the Fraud Enforcement and Recovery Act of 2009 (FERA...

Tip: Consider method of delivery when developing training

  • Compliance Monitor, Issue 20, May 20, 2009

    An important aspect to consider early in the compliance training development process is the...

Florida health plan company enters $80M agreement to avoid fraud charges

  • Compliance Monitor, Issue 19, May 13, 2009

    On May 5, Tampa-based WellCare Health Plans, Inc. agreed to enter a deferred prosecution agreement...

Q&A: Are all hospital acquired conditions (HACs) also 'never-events'?

  • Compliance Monitor, Issue 19, May 13, 2009

    Q: Are all hospital acquired conditions (HACs) also “never-events”?

Senate approves Fraud Enforcement and Recovery Act

  • Compliance Monitor, Issue 17, April 29, 2009

    On April 28 the Senate approved the Fraud Enforcement and Recovery Act of 2009, a bill designed to...

Tip: Include compliance in a performance evaluation

  • Compliance Monitor, Issue 16, April 22, 2009

    When evaluating the performance of managers and supervisors, factor in adherence to the elements of...

Tip: What to do if there is a noncompliance problem

  • Healthcare Auditing Weekly, Issue 13, April 7, 2009

    Deciding what to do when there’s an instance of wrongdoing may be the hardest part of an...

Mammography Regulation and Reimbursement Report April 2009

  • Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009

    Learn why mammography screening compliance is going down, and its becoming more difficult to find...

Mammography use drops in many states

  • Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009

    Mammography use dropped in most states between 2000 and 2006, but researchers still do not know why.

Shortages loom in breast imaging personnel

  • Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009

    The breast imaging world will be significantly shortstaffed in the next 15–20 years if...

ACR releases self-assessment and education tool

  • Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009

    Physicians in New York recently received a tool to help them assess their skill at reading...

Radiologists’ mammography malpractice risk less than most physicians actually expect

  • Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009

    Providing radiologists with more information about legitimate malpractice risks could encourage...

Signatures not required, but are good practice

  • Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009

    The Centers for Medicare & Medicaid Services (CMS) recently clarified its position that...

Healthcare Auditing Strategies April 2009

  • Health Care Auditing Strategies, Issue 4, April 1, 2009

    This month in Healthcare Auditing Strategies, we go in depth on E/M services audits, outlining...

Houston hospital to pay $9.9M to settle inflated outlier charges

  • Compliance Monitor, Issue 13, April 1, 2009

    Houston’s Methodist Hospital agreed to pay $9.9 million to settle allegations that it...

Quality of care roundtable report released

  • Healthcare Auditing Weekly, Issue 12, March 31, 2009

    On March 23, the OIG and the Health Care Compliance Association (HCCA) released a report that...

CMS edit fails to catch improper transfer claims

  • Healthcare Auditing Weekly, Issue 11, March 24, 2009

    On March 11, the OIG issued a report, which detailed the results of a review of hospital compliance...

Healthcare open to economic woes

  • Health Care Auditing Strategies, Issue 3, March 1, 2009

    As Americans suffer through a severe economic recession, healthcare professionals are discovering...

Healthcare Auditing Strategies, March 2009

  • Health Care Auditing Strategies, Issue 3, March 1, 2009

    This month in Healthcare Auditing Strategies, we take a close look at the ailing economy?s effects...

Tip: Retain patient emails

  • Compliance Monitor, Issue 8, February 25, 2009

    HIPAA requires covered entities to manage electronic protected health information , including that...

Anesthesiologist convicted of violating federal False Claims Act

  • Compliance Monitor, Issue 8, February 25, 2009

    On February 19, a federal jury found Eugene Chen, M.D., a Las Vegas anesthesiologist, guilty of...

Tip: Seven steps to establish by-department monitoring

  • Healthcare Auditing Weekly, Issue 6, February 17, 2009

    While there is no right or wrong way to set up a compliance-monitoring program, we have created a...

Two more hospital executives arrested in LA Skid Row scheme

  • Compliance Monitor, Issue 5, February 4, 2009

    A federal indictment named two more individuals in an alleged Medicare fraud scheme that recruited...

Tip: Assess risk, know organization through interviews

  • Healthcare Auditing Weekly, Issue 5, February 3, 2009

    When assessing risk, it’s crucial to have a solid understanding of your organization, the...

Make Stark compliance a priority this year

  • Health Care Auditing Strategies, Issue 2, February 1, 2009

    Upcoming changes to Stark Law should put financial arrangement audits at the top of compliance...

Don’t forget about Medicaid: 2009 OIG Work Plan highlights compliance concerns

  • Health Care Auditing Strategies, Issue 2, February 1, 2009

    The OIG characteristically included many Medicare reviews, audits, and investigations in its 2009...

Know the rule for billing inpatient-only procedures

  • Health Care Auditing Strategies, Issue 2, February 1, 2009

    Although the rule for inpatient-only procedures in an outpatient setting may initially seem rather...

Tip: Follow EMTALA compliance steps to avoid violations

  • Healthcare Auditing Weekly, Issue 4, January 27, 2009

    It’s important to understand the details of the Emergency Medical Treatment and Active Labor...

Tip: Questions the compliance officer should as the board of directors

  • Healthcare Auditing Weekly, Issue 3, January 20, 2009

    Consider adapting some of the following questions to query the board of directors regarding their...

Seven NY hospitals charged with Medicaid fraud

  • Compliance Monitor, Issue 2, January 14, 2009

    Seven hospitals in New York have been accused of fraudulently billing the Medicaid program for...

Boston facilities settle false claims charges

  • Compliance Monitor, Issue 2, January 14, 2009

    Boston Medical Center (BMC) and East Boston Neighborhood Health Center (EBNHC) agreed to pay...

Tip: Ensure ABN compliance with regular auditing

  • Healthcare Auditing Weekly, Issue 2, January 13, 2009

    Follow these tips to audit the use of advance beneficiary notices (ABNs) in your facility and...

HCCA survey shows compliance concerns in poor economy

  • Healthcare Auditing Weekly, Issue 2, January 13, 2009

    The sagging economy is causing concern for healthcare compliance and ethics professionals...

Cardiologist convicted on 51 counts of fraud

  • Compliance Monitor, Issue 1, January 7, 2009

    On December 30, 2008, a federal jury convicted Dr. Mehmood Patel, of Lafayette, LA, on 51 counts of...

Ease your compliance worries: Get ready for 2009

  • Health Care Auditing Strategies, Issue 1, January 1, 2009

    With the government stepping up its efforts to combat Medicare and Medicaid fraud and abuse...

Tip: Reviewing policies and procedures

  • Compliance Monitor, Issue 92, December 31, 2008

    The HHS-OIG Supplemental Compliance Program Guidance for Hospitals recommends considering the...

Tip: Refer to OIG guidance for compliance program fundamentals

  • Healthcare Auditing Weekly, Issue 49, December 30, 2008

    The OIG’s Supplemental Compliance Program Guidance for Hospitals outlines seven elements of...

Three more sentenced in Miami for Medicare fraud

  • Compliance Monitor, Issue 91, December 24, 2008

    Ana Alvarez-Jacinto and Sandra Mateos were sentenced to 30 years in prison for their involvement in...

Tip: Engage your audience when conducting compliance training

  • Healthcare Auditing Weekly, Issue 48, December 23, 2008

    When conducting compliance education sessions, plan how you will keep your trainees&rsquo...

Tip: How to keep the board of directors updated

  • Compliance Monitor, Issue 90, December 17, 2008

    The compliance officer must inform the board of directors about the basic responsibilities of...

Tip: Address anti-kick back statutes and Stark Law

  • Healthcare Auditing Weekly, Issue 47, December 16, 2008

    According to the OIG’s Supplemental Compliance Program Guidance for Hospitals, hospitals...

Step up HIPAA compliance through auditing measures

  • Health Care Auditing Strategies, Issue 1, December 12, 2008

    With the focus on enforcement increasing in many areas of healthcare compliance, auditors need to...

Two TN hospitals settle false claims allegations

  • Compliance Monitor, Issue 89, December 10, 2008

    Jackson Madison General Hospital, in Jackson TN, and Milan General Hospital, in Milan, TN, agreed...

Tip: Resources for risk identification

  • Compliance Monitor, Issue 88, December 3, 2008

    Tip: Resources for risk identification

Manchester Memorial settles false claims allegations

  • Compliance Monitor, Issue 88, December 3, 2008

    Manchester Memorial Hospital in Manchester, CT agreed to pay the federal government $712,000 to...

Condell Medical Center pays $36M after self-disclosing false claims violations

  • Compliance Monitor, Issue 88, December 3, 2008

    Condell Medical Center, in Libertyville, IL, will pay the federal government and the state of...

Featured Audit Plan: Observation Services

  • Healthcare Auditing Weekly, Issue 45, December 2, 2008

    Looking for a particular audit plan that may help make your job easier? Turn to the “Audit...

Tip: Audit compliance program to determine effectiveness

  • Healthcare Auditing Weekly, Issue 45, December 2, 2008

    The OIG believes an ongoing evaluation process is critical to a successful compliance program...

Lucrative cath labs raise red flags

  • Health Care Auditing Strategies, Issue 12, December 1, 2008

    Cardiology catheterization labs are big moneymakers in hospitals. However, the potential for big...

Conquer EMTALA on-call provision challenges 

  • Health Care Auditing Strategies, Issue 12, December 1, 2008

    The Emergency Medical Treatment and Active Labor Act (EMTALA) has been around for more than 20...

Examine short stays, avoid overpayment

  • Strategies for Health Care Compliance, Issue 12, December 1, 2008

    When the recovery audit contractor (RAC) demonstration project ended March 27, the evaluation...

Hectic ERs present audit challenges, compliance risks

  • Strategies for Health Care Compliance, Issue 12, December 1, 2008

    The emergency room (ER) is among the most frantic and fast-paced areas in the hospital. Doctors and...

Is your facility prepared for disaster?

  • Strategies for Health Care Compliance, Issue 12, December 1, 2008

    Disasters are not exclusive to any one area. Some areas may be more susceptible to tornados...

Q: How much does an OIG advisory opinion cost?

  • Compliance Monitor, Issue 87, November 26, 2008

     Q: How much does it cost to request an OIG advisory opinion?

PA hospital will pay $1.9 million in Medicare fraud settlement

  • Compliance Monitor, Issue 87, November 26, 2008

    St. Vincent Health System Inc. will pay $1.9 million to settle allegations the company submitted...

Other Issuances: CMS updates FAQs, OIG issues report on Medicare billing for oxaliplatin, and more

  • Medicare Insider, Issue 48, November 25, 2008

    On November 21, CMS issued 41 new/updated frequently asked questions related to Medicare...

CMS Public Events

  • Medicare Insider, Issue 48, November 25, 2008

    CMS Public Events this Week

Tip: Submission of claims for laboratory services

  • Compliance Monitor, Issue 86, November 19, 2008

    Tip: Submission of claims for laboratory services

Other Issuances: None released this week

  • Medicare Insider, Issue 47, November 18, 2008

    Neither CMS nor the OIG released any other significant issuances this week affecting coverage...

CMS Public Events

  • Medicare Insider, Issue 47, November 18, 2008

    CMS Public Events this Week

Tip: Determine if benefits outweigh risks when it comes to voluntary disclosure

  • Healthcare Auditing Weekly, Issue 42, November 11, 2008

    The balancing of benefits and risks of voluntary disclosure is complex and should be undertaken...

Ensure coders submit compliant claims

  • Strategies for Health Care Compliance, Issue 11, November 1, 2008

    Physician documentation plays a big part of the billing process in medical facilities. But no...

Proceed to EHR with caution, planning

  • Health Care Auditing Strategies, Issue 11, November 1, 2008

    Slowly but surely, providers are moving toward adoption of electronic health records (EHR) in hopes...

Q&A: Transfer agreements

  • Compliance Monitor, Issue 83, October 29, 2008

    Q: The hospital to the south of us has a transfer agreement with a hospital seven miles to our...

NJ hospital pays $1.75 million to settle whistleblower claims

  • Compliance Monitor, Issue 83, October 29, 2008

    NJ hospital pays $1.75 million to settle whistleblower claims

Tip: Follow the OIG's suggestions for monitoring compliance program

  • Healthcare Auditing Weekly, Issue 41, October 28, 2008

    Auditing alone is not enough to maintain an effective compliance program. Organizations must...

Tip: Retention of records

  • Compliance Monitor, Issue 82, October 22, 2008

    Tip: Retention of records

Tip: Stay involved and informed in your role at your organization?s compliance program

  • Healthcare Auditing Weekly, Issue 40, October 21, 2008

    Your involvement as a compliance officer and/or auditor can help improve your organization’s...

Tip: Reporting hotline activity to the board of directors

  • Compliance Monitor, Issue 80, October 15, 2008

    Tip: Reporting hotline activity to the board of directors

Tip: Guidelines for documenting screening treatment

  • Compliance Monitor, Issue 78, October 8, 2008

    Tip: Guidelines for documenting screening treatment

Ask these questions about your compliance program

  • Healthcare Auditing Weekly, Issue 38, October 7, 2008

    An effective auditor acts quickly to interpret new information and educate staff and providers when...

Tip: Create open lines of communication

  • Compliance Monitor, Issue 76, October 1, 2008

    Tip: Create open lines of communication

NJ Hospital pays $3.85M to settle Medicare fraud charges

  • Compliance Monitor, Issue 76, October 1, 2008

    NJ Hospital pays $3.85M to settle Medicare fraud charges

Beware when developing gift-giving policies

  • Health Care Auditing Strategies, Issue 10, October 1, 2008

    “Buy one, get one free!” “Stay at our hotel and receive a free continental...

Tip: Develop a work plan post risk assessment

  • Healthcare Auditing Weekly, Issue 37, September 30, 2008

    After you have completed a comprehensive risk assessment of your organization, it is time to take...

Tip: Exit interview red flags

  • Compliance Monitor, Issue 74, September 24, 2008

    Tip: Exit interview red flags

Staten Island University Hospital to pay $89 million to settle fraud claims

  • Compliance Monitor, Issue 72, September 17, 2008

    Staten Island University Hospital to pay $89 million to settle fraud claims

Tip: Perform a post-audit evaluation to assess strengths and weaknesses

  • Healthcare Auditing Weekly, Issue 35, September 16, 2008

    After the audit report is issued, the audit team should perform a post-audit evaluation. Its...

Tip: Five ways to prevent would-be whistleblowers

  • Healthcare Auditing Weekly, Issue 34, September 9, 2008

    Tip: Five ways to prevent would-be whistleblowers

Tip: How to handle media requests

  • Compliance Monitor, Issue 68, September 3, 2008

    Tip: How to handle media requests

Whistleblowers help the government recoup $9.3 billion

  • Compliance Monitor, Issue 68, September 3, 2008

    Whistleblowers help the government recoup $9.3 billion

Featured Audit Plan: Compliance Effectiveness

  • Healthcare Auditing Weekly, Issue 33, September 2, 2008

    Looking for a particular audit plan that may help make your job easier? Turn to the "Audit...

Tip: How to handle instances of noncompliance

  • Healthcare Auditing Weekly, Issue 33, September 2, 2008

    Deciding what to do when there’s an instance of wrongdoing may be the hardest part of an...