Billing monitoring: Weakest link or greatest strength?
It is well known from the various compliance program guidance documents issued by the Department of Health and Human Services…
When and How Should a Hotline Vendor Be Re-Evaluated?
Most health care organizations have been using a compliance hotline vendor for many years. Anyone with the same hotline vendor…
Developing and Managing Compliance Policy Documents
Developing, implementing, and disseminating written compliance documents is a major foundation of any compliance program, both in terms of organization…
Developing and Managing Compliance Policy Documents: Always Use Caution When Developing Documents for Your Organization
Developing, implementing, and disseminating written compliance documents is a major foundation of any compliance program, both in terms of organization…
How Effective Is Your Compliance Hotline? Steps On How To Improve
As the Compliance or Privacy Officer, do you feel a bit like the memorable Maytag repairman whose phone never rang…
Evidencing Effectiveness In Compliance Training
The compliance officer’s primary responsibilities include developing, coordinating, and participating in a multifaceted educational and training program that focuses on…
No Managed Care Organization Should Allow a Gap between Compliance Officers
Medicare Parts C & D programs require managed care organizations (MCOs) to develop and implement effective compliance programs that include having a compliance officer…
Mergers and Acquisitions Due Diligence in Health Care
Hardly a day passes when the press doesn’t report on a new merger or acquisition in the health care sector. The trend…
Dissecting the Internal Audit Function in Health Care
The traditional role of the internal auditor is to independently and objectively analyze, review, and evaluate existing procedures and activities as well as report…
New Changes Proposed for the Medicare Advantage and Prescription Drug Benefit Programs (CMS-4159-P)
The Part D Medicare prescription drug benefit was enacted as part of the Medicare Modernization Act of 2003 and provides extensive drug coverage…
6,000 Whistleblowers and Still Counting
In 2013, the U.S. Department of Justice (DOJ) reported having secured $3.8 billion in settlements and judgments from civil cases…
Essential Policies And Procedures For Effective Hotline Programs
Hotlines are an essential communication channel for healthcare organizations and serve as a key component in their compliance programs. Hotlines…