Search Results: independent
Accountable Care Organizations Final Rule – Are Your Compliance Officers Prepared?
The Accountable Care Organization (ACO) is a new model of patient-centered health care that was first introduced under the Affordable…
Statistics in Healthcare – Friend or Foe? – Taking the Compliance Office’s Perspective
Growing Importance of Statistics in Compliance Enforcement Data analytics, data mining, overpayment extrapolation using statistical concepts including sampling, and the overall…
Confidence and Precision in Claims Audits: Quality of the Estimate
The contractor reform in health care brought a consolidation of Medicare contractors and new contractors, as exemplified by the Medicare…
How Effective is Your Compliance Training?
While It Is Important to Have a Robust Program, Don’t Forget That It Also Needs to Be Effective The development…
Tom Herrmann and OIG Discuss IRO Expectations and Requirements
Thomas Herrmann and the HHS OIG Office of Counsel to the Inspector General recently conducted a joint presentation about independent…
One Strategy for Rapidly Developing an Effective Compliance Program
For years, there has been a legal and regulatory mandate for managed care organizations (MCOs) to have an effective compliance program — but now the…
Medicare Part D Compliance: A Day of Reckoning Approaches
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) [1] established the Medicare Part D outpatient prescription drug benefit, which…
Federal Electronic Health Records Incentive Programs
HITECH Act Update: An Overview of the Medicare and Medicaid EHR Incentive Programs Regulations and What It Means for Compliance…
Mergers and Acquisitions Assistance and Due Diligence Review
Due Diligence Review Services Mergers and Acquisition (M&A) Regulatory Due Diligence There is a strong trend for increases in acute care…
Compliance Program Effectiveness Evaluations
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) and other regulatory bodies have called for…
Risk Assessment and Management
Health Care Regulatory Risk Management Regulatory compliance risk management is critical to the success of compliance operations. A robust risk…
Regulatory Analysis
Health Care Regulatory Consulting and Analyses Regulatory problems have become increasingly difficult for health care organizations, bleeding providers out of…