“The secret to my success in reinforcing the value of Compliance’s work comes from partnering with HR. Developing standard interview questions, building leadership competencies, and sticking your neck out to establish strong relationships across the organization are crucial to demonstrating how Compliance delivers value.” – Lisa Herota
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“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
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The recent surge in healthcare fraud has prompted heightened enforcement of the Anti-Kickback Statute (AKS). Government agencies are cracking down on illegal financial arrangements that jeopardize patient care. This article explores the significance of AKS enforcement, the impact on healthcare providers, and strategies for compliance in an evolving regulatory landscape.
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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.
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Urine drug testing overpayments drove up to $216 million in overpayments to Medicare over five years, according to a recent OIG audit report.
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Protect healthcare revenue: reduce the risk of fines and payback for inappropriate outlier payments created by unjustified price increases.
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Build relationships with these key clinical and operational areas – Nursing, Physicians, Revenue Cycle, IT, Sales and Marketing. Help them achieve their goals.
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Enforcement Actions: Sanctions and penalties for hiring excluded individuals in healthcare. Why is it crucial to avoid the risk of hiring excluded individuals? List of Excluded Individuals/Entities (LEIE)
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Complex and billed at a higher rate, OIG added physicians billing for critical care evaluation and management services to the work plan.
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