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…
Are You Prepared to Pass a CMS Managed Care Audit?
The creation of the Medicare Parts C & D programs carried with it requirements to develop and implement an effective compliance program[1].…
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…
A Glimpse of the Future of Compliance Oversight by CMS: Part D Plans Case Study
Hospitals and other providers should take note of what the Centers for Medicare & Medicaid Services (CMS) is learning from…
Tom Herrmann Discusses the New OIG “Responsible Corporate Officer Doctrine.”
In a recent article published in the Journal of Health Care Compliance, Thomas Herrmann provides his perspective on the new…
The New OIG “Responsible Corporate Officer Doctrine”
The DHHS Office of Inspector General (“OIG”) has raised the stakes for health care executives whose companies become involved in a Federal…
HITECH Act Update: An Overview of the Medicare and Medicaid EHR Incentive Programs Regulations
The Health Information Technology for Economic and Clinical Health Act (HITECH Act) was enacted as part of the American Recovery…
OIG releases 2011 Work Plan with Medicare and Medicaid
OIG releases 2011 Work Plan with Medicare and Medicaid initiatives that will impact hospitals, physicians, Medicare contractors and the Medicare…
Tighter Enrollment Standards for Medical Equipment Suppliers
This article provides details about new regulations impacting medical equipment suppliers and the implications of the tighter enrollment standards. About…
Systems Reviews versus Transaction Reviews — A Closer Look at a New Era of Mandatory Compliance
A New Era of Mandatory Healthcare Compliance Programs Compliance programs initially were voluntary in the healthcare industry. Eventually managed care…
Systems Reviews versus Transaction Reviews in CIAs: Takeaways for Compliance Officers
Most compliance officers do not have to face the scrutiny and challenges of operating a compliance program under a Corporate…
CMS RAC Audits: Complex Review Issues
Although the Centers for Medicare and Medicaid Services (CMS) implemented the Recovery Audit Contractor (RAC) as a permanent program over a year…