Blog: compliance programs

 

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Office Inspector General Launches New Compliance Resource Portal

Posted on April 30, 2018 by
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At a recent Health Care Compliance Association (HCCA) compliance institute, the Office of Inspector General announced it had launched a new resource portal focused on compliance issues.  A trip to the OIG’s web site, and sure enough, there is a brand spankin’ new compliance portal.  You can check out the portal at OIG Portal. On […]

Medicaid Fraud Control Units Report Focus on Personal Care Services

Posted on June 27, 2017 by
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The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released a report summarizing activities of State Medicaid Fraud Control Units (MFCUs or Units) for fiscal year 2016.  The OIG is the designated Federal agency for oversight of state MFCUs.  The report found a total of 1,564 convictions of which approximately […]

Lessons from OCR HIPAA Settlements – Mobile Device Security Standards

Posted on May 3, 2017 by
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In the first known case involving a wireless provider, a cardiology service provider agreed to pay a $2.5 million settlement based on the impermissible disclosure of unsecured electronic protected health information (ePHI).  The company provides remote mobile monitoring of and rapid response to patients at risk for cardiac arrhythmias.  The company disclosed to the Office […]

Best Practices in Compliance Program Operation

Posted on April 4, 2017 by
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Given the increased importance of compliance, it is helpful for providers to get a feel for what constitutes “best practice” when operating a compliance program.  “Best Practices” is a term thrown around all of the time in the business world.  It is used in many contexts and takes on a variety of meanings depending on […]

Compliance Budgeting – Put Your Money Where Your Mouth is

Posted on March 30, 2017 by
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You have adopted your basic compliance policies and procedures, established a reporting system and visibly rolled out your new compliance program.  Your board of directors has passed a resolution decisively stating its commitment to compliance.  The CEO issued a letter stating her commitment to compliance and mandating every person in the organization follow the Code […]

Physician Practice Compliance Programs

Posted on March 14, 2017 by
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In today’s environment of complex regulations, aggressive prosecution, exorbitant penalties, and hungry whistleblower attorneys, it is necessary for medical practices to maintain effective compliance programs.  Failure to do so puts the practice at a great deal of unnecessary risk.  Many or most practices will eventually make errors in their billing and collections or other regulatory […]

Chiropractic Service Overpayment for Lack of Medical Necessity

Posted on February 27, 2017 by
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Recent OIG Release Emphasizes Need for Compliance Policies Specific to Provider Risks The Office of Inspector General recently published results of its audit of Medicare claims for chiropractic services made by a chiropractic group in Kansas.  The review concluded the groups received over $725,000.00 in overpayments in calendar years 2011 and 2012. In its report, […]

The Role of Confidentiality Agreements in a Corporate Compliance Program

Posted on June 26, 2014 by
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A recent federal court decision from Pennsylvania illustrates the importance of a confidentiality agreement as part of a compliance program. The Pennsylvania court found that a confidentiality agreement that had been signed by an employee restricted the ability of the whistleblower claimant to use confidential information to support its qui tam claim under the federal […]