regulatory change management

Increasing Enforcement of Modifier Codes

“Enforcement agencies like to “follow the money,” so to speak, and they often find it in medical claims submitted to government payors such as Medicare and Medicaid. This is why selecting appropriate modifier codes is essential for operating and being reimbursed compliantly.”

Three Ways to Take a Service-Minded Approach to Compliance

“We’re continually being asked for advice to help our healthcare leaders. Essentially, we are acting as a customer service representative. For that reason, if you want to improve the culture of compliance and get those leaders’ buy-in, then make sure you’re delivering great service when consulting to them.”

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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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Telehealth Enforcement Actions

“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.”

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How to Create Champions of Healthcare Compliance  

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.

Anstine CCO compliance Compliance Culture compliance officer healthcare hospitals Jay Jay P. Anstine regulations regulatory change management

Complexities of Covered Entities and Business Associates

complexities of covered entities shawn degroot

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.

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Limit Second-Hand Stress to Help Build a Healthy Compliance Culture in Healthcare

build a healthy compliance culture jay anstine

In the complex and demanding field of healthcare, maintaining a healthy compliance culture is crucial to ensure quality care and mitigate risks. However, an often overlooked aspect of building such a culture is the impact of second-hand stress on healthcare professionals. This article delves into ways to properly manage second-hand stress and maintain a healthy compliance culture.

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Four Ways to Engage Leaders in a Culture of Compliance

Building positive, proactive relationships with leaders is crucial to a culture of compliance. Four approaches to engage leaders in an effective compliance program.

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Sanctions and penalties for hiring excluded individuals in healthcare

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)

CJ Wolf HHS LEIE List of Excluded Individuals/Entities Mandatory exculsions Office of Inspector General OIG Permissive exclusions regulatory change management risk US department of health and human services