Christi Grimm, the Inspector General of HHS, gave a recent keynote address to compliance professionals. In it, she said, “Simply put, the financial incentives created by risk adjustment may be driving upcoding in the severity of diagnoses to garner additional payments.”
Continue reading
If we want to improve our organizations’ compliance culture, then we need to interact with our healthcare leaders in a way that sells compliance without “selling” compliance.
Continue reading
“It behooves all healthcare compliance professionals to be aware of the fraud, waste and abuse risks associated with telehealth services. This mode of delivery holds great promise. For it to fulfill that promise, non-compliance needs to be rooted out and corrected.”
Continue reading
“My success in uncovering millions of dollars in unbilled services demonstrates how revenue protection is a tangible way Compliance delivers value to healthcare organizations. It also underscores how compliance professionals make an impact across the business through building relationships, shaping culture, preventing fines, and positioning Compliance as true partner.” – Maeve O’Neill
Continue reading
“Privacy can make or break an organization. For healthcare systems in particular, it’s essential to lock down data … there are two sides to privacy: the positive benefit side and penalty side ….” – Jerry Shafran, CEO and Founder of YouCompli
Continue reading
From fostering a culture of accountability to providing robust training programs, this insightful piece offers practical steps to enhance compliance, reduce risks, and ensure patient safety. Discover how organizations can navigate the complex regulatory environment and cultivate a workforce committed to upholding the highest standards of compliance. Read the full article for a comprehensive roadmap to success in healthcare compliance.
Continue reading
Due to their violations of patient rights, covered entities and business associates are now facing increasing enforcement actions. In a breach, both parties bear financial and reputational risk. Shawn DeGroot recommends proactive compliance officers prioritize their agreements based on risk, establish communication channels, and collaborate on risk analysis to protect their organization.
Continue reading
Healthcare risk assessments are essential for patient safety and compliance. By understanding the why, what, who, and when of risk assessments, healthcare organizations ensure high-quality care in a safe environment. In this article, Sharon Parsley discusses risk assessment from a “why, what who, and when” perspective. She also looks at ways that you, as an effective compliance officer, can lead this process with your colleagues.
Continue reading
Compliance must build relationships with these healthcare functions – Legal, Internal Audit, Human Resources and Quality. Here are suggestions on how to effectively build relationships and collaborate with them to help achieve their goals.
Continue reading