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Exclusion Screening Failure Causes Compliance Nightmare

“ABC Health, a mid-sized midwestern provider, was thriving. With a regional flagship hospital, six outpatient clinics, a home health division, and a solid reputation for quality care, the CEO had just signed a five-year partnership with a major insurance network.

There didn’t seem to be any cause for worry. The compliance officer insisted they ran exclusion screenings every quarter—plenty often, the executive claimed.

But in Q3, the exclusion screening software glitched. It missed a monthly sync. Then a second. By the third missed month, the compliance officer dismissed it as “a minor lag,” promising the HR department everything would be rerun soon.

Unfortunately, even a seemingly small glitch can have major consequences for healthcare compliance.”

Ensuring Compliance for Academic Medical Centers

“The U.S. government has recently increased its focus on foreign influence in academic research – which some call ‘academic espionage.’”

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How the OIG’s New General Compliance Program Guidance (GCPG) Addresses the Seven Elements

“Compliance officers can make the most of the new GCPG to meet the requirements of the OIG’s seven elements in a relevant and meaningful way.”

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Mitigating Risks from Online Tracking Technologies

“To protect patients’ privacy and adhere to federal law, compliance professionals must understand what online patient data is being tracked and used by their organization’s website, social media pages, and payment portals.”

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Our Youth Mental Health Crisis: How Compliance Can Help Providers Address It

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“While youth intervention is not a traditional focus for compliance professionals, they have a vital role to play here. Ensuring that assessment tools are easily available for pediatric providers is critical.”

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Improving Patient Care With a “Prevent, Detect, Report” Strategy

patient care, prevent detect strategy report denise atwood

“This three-pronged strategy focuses on educating patients and staff about how to avoid misconduct. It also emphasizes training individuals on how to recognize and report FWA violations when they see them.”

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How to Deliver Patient-Centered Care in a Post-Covid World

A “reframe, regroup, refocus” approach enables compliance teams to work with other departments to provide excellent patient-centered care.

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The Why, What, Who, and When of Healthcare Risk Assessments

sharon parsley reasons for healthcare risk assessments

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.

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Establishing a Strong Compliance Culture in Behavioral Healthcare: Part 1

strong compliance culture in behavioral healthcare maeve o'neill

Stigma and complexities of behavioral health create the need to minimize compliance risk through predictable processes, metrics, and the OIG’s 7 elements.

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