There are times when outsourcing healthcare compliance services can become a practical and pragmatic option. Consider the following … In this Article … Boardroom Realizations: Navigating Healthcare Compliance Concerns Compliance…
What is Considered “Protected Health Information”?
Descriptions of what is considered HIPAA-protected health information (PHI) have been around since the enactment of the Health Insurance Portability and Accountability Act in 1996. Congress did not enact specific…
HIPAA Privacy Officer vs. Security Officer – what’s the difference?
Understanding HIPAA regulations requires knowing the distinct roles of a HIPAA Privacy Officer and a HIPAA Security Officer. This article breaks down their unique responsibilities and shows why both are…
Stark Law Violation: Insights Prompted by a Record Penalty
Late last year, the U.S. Department of Justice (DOJ) announced a False Claims Act (FCA) settlement with a large hospital system. The settlement was noteworthy for two reasons. It was…
HTI-1 Final Rule Update: Impact on EHR and Health IT
In this Article … Health Data, Technology, and Interoperability – Some Background The United States Core Data for Interoperability Version 3 (USCDI v3) Electronic Case Reporting Decision Support Intervention Predictive…
Medical Practice Embezzlement – Detection & Protection
Here is something no one likes to think about, much less admit: a trusted employee embezzled money from your practice, possibly for years! Medical practice embezzlement, a type of occupational…
Implementing the 7 Elements of an Effective Compliance Program
The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued a document entitled General Compliance Program Guidance in November 2023. The OIG’s stated…
Healthcare Compliance Training: an essential guide
Staying informed and compliant with regulatory standards is not just a best practice—it’s a necessity for healthcare providers. This is certainly true when it comes to the details of healthcare…
Your Corporate Integrity Agreement: what will the IRO audit?
Corporate Integrity Agreements (CIAs) can be overwhelming for those healthcare organizations facing one. Tasked with rectifying past non-compliance, these agreements are a roadmap to regaining trust and ensuring future adherence…
The Compliance Committee: Steering Integrity in Healthcare
In Part 1 of this two-part series, we discussed the role of the new Compliance Officer. We described the activities in terms of the first day, the first week, and…
New Compliance Officer in Healthcare: 1st day, week & month
This is Part 1 of a two-part series on compliance officers and compliance committees in a healthcare setting. In this part, we discuss how a new compliance officer should undertake…
Fostering a Culture of Compliance in Healthcare
There is a lot of discussion these days about the culture. You can read about how it is crumbling, or you can hear about how it is expanding to encompass…
The Ultimate Guide to Medical Office HIPAA Compliance
The original Health Insurance Privacy and Accountability Act (HIPAA) was passed in 1996. The HIPAA Privacy Rule, a part of the HIPAA Administrative Simplification regulations, has been in effect for…
HIPAA Security Rule: Technical Safeguards
The HIPAA security rule technical specifications are one of the three required safeguards of the HIPAA Security Rule. The Physical safeguards focus on policies and procedures for aspects such as how…
HIPAA Security Rule, Computers, and Administrative Safeguards
It’s been almost 27 years since the Health Insurance Portability and Accountability Act of 1996 was passed by Congress. And it’s been almost 20 years since the initial adoption of…
HIPAA Business Associate (Definition, Agreement, and More)
The original HIPAA Privacy Rule of 2003 included provisions for Covered Entities (health care providers, health insurance issuers, and health care clearinghouses) to share protected health information on behalf of…
Hospital Price Transparency – Boon or Bust?
Price Transparency – it’s something we expect in almost everything else we consider purchasing, right? So why shouldn’t we expect hospital price transparency as well? That is undoubtedly what members…
Code of Conduct for Healthcare – 18 things to include
Many healthcare organizations of any size have a Code of Conduct. These codes are designed to demonstrate the organization’s dedication to ethical behavior and compliance with the healthcare services organization’s…
When can the OCR Audit You?
If you are wondering just when can the OCR audit your covered entity or business associate organization, you may conclude “any time it darn well wants to”. Well, that’s an…
Denial Management in Healthcare – Be Proactive
Denial management in healthcare – sounds like a topic that Chief Financial Officers and Revenue Cycle Directors are very interested in. However, in today’s environment, where every bit of lost…