Corporate Compliance Articles by Topic: Hospital Compliance
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Medicare Insider, Issue 23, June 7, 2011
HHS has posted its plan for retrospective review of existing regulations.
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Compliance Monitor, Issue 22, June 1, 2011
On Thursday, May 26, the Department of Health and Human Services (HHS) announced its plans to...
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Compliance Monitor, Issue 18, May 4, 2011
The number of entities reporting breaches of unsecured PHI affecting at least 500 individuals to...
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Compliance Monitor, Issue 18, May 4, 2011
When evaluating the performance of managers and supervisors, factor in adherence to the elements of...
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Compliance Monitor, Issue 16, April 20, 2011
Dallas-based Tenet Healthcare Corp. filed a Medicare fraud lawsuit that accuses Community Health...
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Compliance Monitor, Issue 16, April 20, 2011
An effective compliance program should incorporate periodic (at least annual) reviews to determine...
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Medicare Insider, Issue 16, April 19, 2011
On April 13, HHS published in the Federal Register a request for information regarding its...
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Medicare Insider, Issue 15, April 12, 2011
CMS and the OIG have published rulemaking on accountable care organizations (ACO) and applicable...
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Compliance Monitor, Issue 14, April 6, 2011
Carolyn Ann Vasquez of Los Angeles pleaded guilty to using fraudulent medical clinics and the...
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Compliance Monitor, Issue 14, April 6, 2011
CMS has issued MLN Matters Article MM7350 to explain how the new provider enrollment provisions...
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Compliance Monitor, Issue 13, March 30, 2011
CMS has issued a final rule to implement provisions of the Patient Protection and Affordable Care...
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Medicare Insider, Issue 13, March 29, 2011
On March 23, CMS published in the Federal Register a notice to announce the
$505 calendar year...
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Compliance Monitor, Issue 12, March 23, 2011
Saints Medical Center in Lowell, MA, will pay $579,000 to settle alleged Medicare billing...
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Compliance Monitor, Issue 12, March 23, 2011
New York has a mandatory compliance program model already in place, and the federal government is...
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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...
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Compliance Monitor, Issue 10, March 9, 2011
Senator Chuck Grassley introduced legislation to build on key reforms to fight fraud in Medicare...
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Compliance Monitor, Issue 10, March 9, 2011
Jummal Joy Ibrahim, 55, of Las Vegas pleaded guilty to falsely representing to Medicare that she...
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Compliance Monitor, Issue 10, March 9, 2011
An owner and a physician associated with a Detroit-area infusion therapy clinic will serve 120...
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Compliance Monitor, Issue 10, March 9, 2011
One crucial element of a good compliance program is having a supportive board and senior management.
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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...
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Compliance Monitor, Issue 9, March 2, 2011
The General Hospital Corporation and Massachusetts General Physicians Organization, Inc., (Mass...
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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...
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Compliance Monitor, Issue 8, February 23, 2011
The Medicare Fraud Strike Force charged 111 defendants in nine cities for their alleged...
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Compliance Monitor, Issue 8, February 23, 2011
Twenty southern Florida residents were indicted for various healthcare fraud, kickback, and money...
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Compliance Monitor, Issue 8, February 23, 2011
The office manager of a Los Angeles durable medical equipment (DME) company pleaded guilty today to...
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Compliance Monitor, Issue 7, February 16, 2011
The New York City Health and Hospitals Corporation (HHC) must notify 1.7 million patients, hospital...
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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...
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Medicare Insider, Issue 6, February 8, 2011
CMS published in the Federal Register a final rule to implement provisions of the Patient...
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Medicare Insider, Issue 5, February 1, 2011
CMS has issued a display copy of a final rule to implement provisions of the Patient Protection...
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Compliance Monitor, Issue 4, January 26, 2011
The government’s healthcare fraud and abuse efforts netted more than $4 billion in fiscal...
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Compliance Monitor, Issue 3, January 19, 2011
Renier Vicente Rodriguez Fleitas, 60, of Miami-Dade County, will serve 37 months after pleading...
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Compliance Monitor, Issue 3, January 19, 2011
Edward Birts, 51, will serve more than five years in federal prison without parole and pay more...
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Compliance Monitor, Issue 3, January 19, 2011
University Medical Center in Tucson, AZ, fired three clinical support staff members and a...
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Compliance Monitor, Issue 2, January 12, 2011
Dahlia V. Kirkpatrick, MD, and Emmanuel M. Komandu, the owner and operator of Alpha Medical...
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Compliance Monitor, Issue 1, January 5, 2011
Detroit Medical Center agreed to pay the United States $30 million to settle allegations that it...
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Compliance Monitor, Issue 1, January 5, 2011
In two separate Federal Register issues, the Office of Inspector General (OIG) and CMS solicited...
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Compliance Monitor, Issue 48, December 22, 2010
Bernice Brown, 56, the owner of a Detroit-area physical therapy clinic, and Daniel Smorynski, 63...
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Compliance Monitor, Issue 48, December 22, 2010
Alan Silber, MD, will serve 36 months in prison for participating in a scheme to defraud the...
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Compliance Monitor, Issue 48, December 22, 2010
Q: Our nursing staff continues to tape patient intake and output sheets outside of patient...
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Compliance Monitor, Issue 47, December 15, 2010
Ken B. Beverly, former CEO of Thomasville, GA–based Archbold Memorial Hospital, was convicted...
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Compliance Monitor, Issue 47, December 15, 2010
The HIPAA Privacy Rule requires that access to and disclosure of protected health information (PHI...
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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...
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Compliance Monitor, Issue 46, December 8, 2010
Q: What is fraud?
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Compliance Monitor, Issue 45, December 1, 2010
Creating and facilitating a compliance program is no easy task, so the responsibilities should not...
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Compliance Monitor, Issue 44, November 24, 2010
U.S. District Judge Adalberto Jordan sentenced Jose Garcia, 55, to 57 months in prison for...
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Compliance Monitor, Issue 42, November 10, 2010
Simi Valley (CA) Hospital paid the United States $5.1 million to resolve allegations that its...
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Compliance Monitor, Issue 41, November 3, 2010
The Christ Hospital (TCH) of Cincinnati, OH, and the Office of Inspector General (OIG) entered into...
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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...
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Compliance Monitor, Issue 41, November 3, 2010
A Houston-based patient recruiter pleaded guilty in connection with a $5.2 million Medicare fraud...
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Compliance Monitor, Issue 41, November 3, 2010
If your facility has a robust compliance department, the recovery audit contractor (RAC) team may...
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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...
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Compliance Monitor, Issue 34, September 1, 2010
A Santa Monica, CA hospital will pay the United States $5.25 million to resolve allegations that...
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Compliance Monitor, Issue 34, September 1, 2010
Survey: Tax-exempt status
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Compliance Monitor, Issue 28, July 21, 2010
The Medicare Fraud Strike Force charged 94 people for their alleged participation in various...
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Compliance Monitor, Issue 28, July 21, 2010
Two Detroit citizens pleaded guilty in U.S. District Court for their roles in a Medicare home...
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Compliance Monitor, Issue 22, June 9, 2010
A Minnesota-based heart device manufacturer, St. Jude Medical Inc., and two hospitals will pay...
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Compliance Monitor, Issue 20, May 26, 2010
The Health Alliance of Greater Cincinnati and one of its former member hospitals, The Christ...
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Compliance Monitor, Issue 19, May 19, 2010
Nine hospitals in seven states will pay the United States more than $9.4 million combined to...
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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...
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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...
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Compliance Monitor, Issue 14, April 14, 2010
Survey: Compliance teammates
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Compliance Monitor, Issue 13, April 7, 2010
Tip: Adhere to U.S. sentencing guidelines
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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...
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Compliance Monitor, Issue 9, March 3, 2010
Brookhaven Memorial Hospital Medical Center in Long Island, NY, will pay $2.92 million to resolve...
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Medicare Insider, Issue 5, February 2, 2010
CMS issued no significant regulations affecting hospital billing this week.
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Compliance Monitor, Issue 3, January 20, 2010
A federal judge charged Scott Reuben, chief of acute pain at Bay State Hospital in Springfield, MA...
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Compliance Monitor, Issue 3, January 20, 2010
Q: Is it permissible to fax patient medical records between physicians without patient...
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Compliance Monitor, Issue 1, January 6, 2010
Wheaton Community Hospital and Stanley Gallagher, MD, (collectively WCH) agreed to pay $846,000 to...
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Compliance Monitor, Issue 52, December 30, 2009
Trinity Health agreed to pay $205,000 to settle claims that its subsidiary hospital, St. Joseph...
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Compliance Monitor, Issue 50, December 16, 2009
Creating and facilitating a compliance program is no easy task, so the responsibilities should not...
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Compliance Monitor, Issue 49, December 9, 2009
Mercy Medical Center in Sioux City, IA, will pay $400,000 to settle allegations of inflating...
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Compliance Monitor, Issue 44, November 4, 2009
A Texas hospital group will pay the United States $27.5 million to resolve allegations that it...
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Medicare Insider, Issue 45, November 3, 2009
CMS has released a display copy of the outpatient prospective payment system (OPPS) final rule for...
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Compliance Monitor, Issue 36, September 9, 2009
Pharmaceutical giant Pfizer Inc. and its subsidiary Pharmacia & Upjohn Company Inc. will pay...
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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...
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Compliance Monitor, Issue 32, August 12, 2009
One way to strengthen your compliance department is to designate a compliance committee. A...
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Compliance Monitor, Issue 26, July 1, 2009
If the compliance officer or committee discovers evidence of misconduct or noncompliance and has...
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Compliance Monitor, Issue 25, June 24, 2009
Robert Bourseau, former board member and co-owner of City of Angels Medical Center in Los Angeles...
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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...
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Compliance Monitor, Issue 21, May 27, 2009
On May 20, President Barack Obama signed the Fraud Enforcement and Recovery Act of 2009 (FERA...
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Compliance Monitor, Issue 20, May 20, 2009
An important aspect to consider early in the compliance training development process is the...
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Compliance Monitor, Issue 19, May 13, 2009
On May 5, Tampa-based WellCare Health Plans, Inc. agreed to enter a deferred prosecution agreement...
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Compliance Monitor, Issue 19, May 13, 2009
Q: Are all hospital acquired conditions (HACs) also “never-events”?
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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...
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Compliance Monitor, Issue 16, April 22, 2009
When evaluating the performance of managers and supervisors, factor in adherence to the elements of...
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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...
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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...
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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.
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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...
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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...
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Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009
Providing radiologists with more information about legitimate malpractice risks could encourage...
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Mammography Regulation and Reimbursement Report, Issue 4, April 1, 2009
The Centers for Medicare & Medicaid Services (CMS) recently clarified its position that...
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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...
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Compliance Monitor, Issue 13, April 1, 2009
Houston’s Methodist Hospital agreed to pay $9.9 million to settle allegations that it...
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Healthcare Auditing Weekly, Issue 12, March 31, 2009
On March 23, the OIG and the Health Care Compliance Association (HCCA) released a report that...
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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...
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Health Care Auditing Strategies, Issue 3, March 1, 2009
As Americans suffer through a severe economic recession, healthcare professionals are discovering...
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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...
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Compliance Monitor, Issue 8, February 25, 2009
HIPAA requires covered entities to manage electronic protected health information , including that...
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Compliance Monitor, Issue 8, February 25, 2009
On February 19, a federal jury found Eugene Chen, M.D., a Las Vegas anesthesiologist, guilty of...
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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...
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Compliance Monitor, Issue 5, February 4, 2009
A federal indictment named two more individuals in an alleged Medicare fraud scheme that recruited...
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Healthcare Auditing Weekly, Issue 5, February 3, 2009
When assessing risk, it’s crucial to have a solid understanding of your organization, the...
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Health Care Auditing Strategies, Issue 2, February 1, 2009
Upcoming changes to Stark Law should put financial arrangement audits at the top of compliance...
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Health Care Auditing Strategies, Issue 2, February 1, 2009
The OIG characteristically included many Medicare reviews, audits, and investigations in its 2009...
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Health Care Auditing Strategies, Issue 2, February 1, 2009
Although the rule for inpatient-only procedures in an outpatient setting may initially seem rather...
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Healthcare Auditing Weekly, Issue 4, January 27, 2009
It’s important to understand the details of the Emergency Medical Treatment and Active Labor...
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Healthcare Auditing Weekly, Issue 3, January 20, 2009
Consider adapting some of the following questions to query the board of directors regarding their...
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Compliance Monitor, Issue 2, January 14, 2009
Seven hospitals in New York have been accused of fraudulently billing the Medicaid program for...
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Compliance Monitor, Issue 2, January 14, 2009
Boston Medical Center (BMC) and East Boston Neighborhood Health Center (EBNHC) agreed to pay...
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Healthcare Auditing Weekly, Issue 2, January 13, 2009
Follow these tips to audit the use of advance beneficiary notices (ABNs) in your facility and...
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Healthcare Auditing Weekly, Issue 2, January 13, 2009
The sagging economy is causing concern for healthcare compliance and ethics professionals...
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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...
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Health Care Auditing Strategies, Issue 1, January 1, 2009
With the government stepping up its efforts to combat Medicare and Medicaid fraud and abuse...
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Compliance Monitor, Issue 92, December 31, 2008
The HHS-OIG Supplemental Compliance Program Guidance for Hospitals recommends considering the...
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Healthcare Auditing Weekly, Issue 49, December 30, 2008
The OIG’s Supplemental Compliance Program Guidance for Hospitals outlines seven elements of...
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Compliance Monitor, Issue 91, December 24, 2008
Ana Alvarez-Jacinto and Sandra Mateos were sentenced to 30 years in prison for their involvement in...
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Healthcare Auditing Weekly, Issue 48, December 23, 2008
When conducting compliance education sessions, plan how you will keep your trainees&rsquo...
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Compliance Monitor, Issue 90, December 17, 2008
The compliance officer must inform the board of directors about the basic responsibilities of...
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Healthcare Auditing Weekly, Issue 47, December 16, 2008
According to the OIG’s Supplemental Compliance Program Guidance for Hospitals, hospitals...
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Health Care Auditing Strategies, Issue 1, December 12, 2008
With the focus on enforcement increasing in many areas of healthcare compliance, auditors need to...
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Compliance Monitor, Issue 89, December 10, 2008
Jackson Madison General Hospital, in Jackson TN, and Milan General Hospital, in Milan, TN, agreed...
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Compliance Monitor, Issue 88, December 3, 2008
Tip: Resources for risk identification
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Compliance Monitor, Issue 88, December 3, 2008
Manchester Memorial Hospital in Manchester, CT agreed to pay the federal government $712,000 to...
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Compliance Monitor, Issue 88, December 3, 2008
Condell Medical Center, in Libertyville, IL, will pay the federal government and the state of...
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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...
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Healthcare Auditing Weekly, Issue 45, December 2, 2008
The OIG believes an ongoing evaluation process is critical to a successful compliance program...
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Health Care Auditing Strategies, Issue 12, December 1, 2008
Cardiology catheterization labs are big moneymakers in hospitals. However, the potential for big...
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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...
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Strategies for Health Care Compliance, Issue 12, December 1, 2008
When the recovery audit contractor (RAC) demonstration project ended March 27, the evaluation...
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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...
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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...
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Compliance Monitor, Issue 87, November 26, 2008
Q: How much does it cost to request an OIG advisory opinion?
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Compliance Monitor, Issue 87, November 26, 2008
St. Vincent Health System Inc. will pay $1.9 million to settle allegations the company submitted...
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Medicare Insider, Issue 48, November 25, 2008
On November 21, CMS issued 41 new/updated frequently asked questions related to Medicare...
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Medicare Insider, Issue 48, November 25, 2008
CMS Public Events this Week
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Compliance Monitor, Issue 86, November 19, 2008
Tip: Submission of claims for laboratory services
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Medicare Insider, Issue 47, November 18, 2008
Neither CMS nor the OIG released any other significant issuances this week affecting coverage...
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Medicare Insider, Issue 47, November 18, 2008
CMS Public Events this Week
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Healthcare Auditing Weekly, Issue 42, November 11, 2008
The balancing of benefits and risks of voluntary disclosure is complex and should be undertaken...
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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...
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Health Care Auditing Strategies, Issue 11, November 1, 2008
Slowly but surely, providers are moving toward adoption of electronic health records (EHR) in hopes...
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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...
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Compliance Monitor, Issue 83, October 29, 2008
NJ hospital pays $1.75 million to settle whistleblower claims
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Healthcare Auditing Weekly, Issue 41, October 28, 2008
Auditing alone is not enough to maintain an effective compliance program. Organizations must...
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Compliance Monitor, Issue 82, October 22, 2008
Tip: Retention of records
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Healthcare Auditing Weekly, Issue 40, October 21, 2008
Your involvement as a compliance officer and/or auditor can help improve your organization’s...
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Compliance Monitor, Issue 80, October 15, 2008
Tip: Reporting hotline activity to the board of directors
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Compliance Monitor, Issue 78, October 8, 2008
Tip: Guidelines for documenting screening treatment
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Healthcare Auditing Weekly, Issue 38, October 7, 2008
An effective auditor acts quickly to interpret new information and educate staff and providers when...
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Compliance Monitor, Issue 76, October 1, 2008
Tip: Create open lines of communication
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Compliance Monitor, Issue 76, October 1, 2008
NJ Hospital pays $3.85M to settle Medicare fraud charges
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Health Care Auditing Strategies, Issue 10, October 1, 2008
“Buy one, get one free!” “Stay at our hotel and receive a free continental...
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Healthcare Auditing Weekly, Issue 37, September 30, 2008
After you have completed a comprehensive risk assessment of your organization, it is time to take...
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Compliance Monitor, Issue 74, September 24, 2008
Tip: Exit interview red flags
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Compliance Monitor, Issue 72, September 17, 2008
Staten Island University Hospital to pay $89 million to settle fraud claims
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Healthcare Auditing Weekly, Issue 35, September 16, 2008
After the audit report is issued, the audit team should perform a post-audit evaluation. Its...
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Healthcare Auditing Weekly, Issue 34, September 9, 2008
Tip: Five ways to prevent would-be whistleblowers
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Compliance Monitor, Issue 68, September 3, 2008
Tip: How to handle media requests
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Compliance Monitor, Issue 68, September 3, 2008
Whistleblowers help the government recoup $9.3 billion
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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...
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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...
