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…
An Update on Outpatient Therapy Services
The Centers for Medicare & Medicaid Services (CMS) recently issued a Medicare Learning Network (MLN) Matters article listing the therapy codes…
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…
Using Surveys to Evidence Compliance Program Effectiveness
Over the last decade compliance officers and programs have matured and become more sophisticated. The importance of such programs has…
Hospital Risk Assessment: Environmental Health & Safety Compliance, and Physical Security Standards
Are patients, hospital staff and the public protected in your hospital environment? What laws and regulations might the Compliance Office help to…
Conducting Internal Investigations in Health Care Organizations
Conducting Internal Investigations in Health Care Organizations is a practical “how-to” guide written by the former HHS Inspector General and nationally…
Meeting the Privacy Officer Challenge: Outsourcing Might Be the Answer
Imagine discovering an employee’s laptop has been stolen that contained thousands of patient records with protected health information (PHI). Add…
Managed Care Executives at Risk under the OIG Responsible Corporate Officer Doctrine
Managed care organization plan executives are facing increased personal exposure to the OIG’s administrative sanctions under the “Responsible Corporate Officer Doctrine.” In light…
Independent Review Organizations: A Compliance Contract with the HHS Office of Inspector General
On April 12, Thomas Herrmann, a Strategic Management Vice President, held a joint presentation with Felicia Heimer, Senior Counsel, Office…
Taking Control of the CMS Managed Care Audit Process
The creation of the Medicare Parts C & D programs require managed care organizations to develop and implement effective compliance programs. There are…