Developing and Operating a Healthcare Compliance Hotline
A hotline is a critical part of any effective compliance program. It is an important avenue of communication between employees…
The Medicare Appeals Process – Is It Working in 2013?
I. Background Health care providers, suppliers, and beneficiaries may appeal the denial of claims for payment under Medicare Parts A,…
Questions Raised About Necessity, Utility of Debarment Screening
Former HHS Inspector General Richard P. Kusserow invites health care organizations to rethink their use of the General Services Administration’s…
Biggest Mistakes With Sanction Screening
With the Office of Inspector General, CMS, and State Medicaid Agencies all calling for increased and more frequent sanction screening,…
Internal Investigations: Evaluating Allegations
Steps to Consider As You Work Through the Investigative Process Complaints and allegations will arrive via many channels with varying…
How Effective is Your Auditing Hotline Operation?
Hotline Reviews Should Demonstrate How Organizations Encourage Employees to Report Problems More and more legal and regulatory requirements call for having an employee…
EPLS Migrates to SAM with Little Fanfare
It May Take Time to Get Familiar with the New System and Its Nuances With little fanfare, the General Services…
Meeting the Challenge of Corporate Integrity Agreements and Independent Review Organizations
Introduction The Department of Justice (DOJ) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG),…
Corporate Integrity Agreements: IRO Review of Unallowable Costs
A Corporate Integrity Agreement (CIA) outlines the obligations an entity agrees to as part of a civil settlement with the…
Is Healthcare Compliance Outsourcing an Option for Your Compliance Program?
Under the Affordable Care Act, CMS has been charged with developing mandated Healthcare Compliance Program (CP) standards that will be…
SAM Replaces EPLS: How to Make Sure You Are Compliant
Unbeknownst to many in the health care compliance industry, the General Services Administration (GSA) announced it was migrating data from…
Enforcement of HIPAA Updates in 2012
HIPAA violations and enforcement are not exactly what one expects to see when they open up a celebrity gossip magazine…