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All of the talk in the news about obstruction of justice should serve as a reminder of the importance of knowing what you can and can’t do when a government investigation begins.  Several actions that may sound entirely normal and seem legal can be characterized as obstructing justice. For example,…
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With 402 metrics listed in a 55-page guidance sheet, “HCCA-OIG Measuring Compliance Program Effectiveness: A Resource Guide" is a collection of best practices for measuring effectiveness at any U.S. healthcare facility.
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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently conducted an audit of Mount Sinai Hospital in New York City. After looking at a sample, the OIG found fault with about $1.4 million in claims, and projected that to an overpayment of just under $42…
By Laurie A. McBrierty, MLT, ASCP and Cari Greenwood, RHIA, CCS, CPC
Changes in reimbursement policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits. Medicare audits have increased 936 percent in the last five years alone, according to Becker’s Hospital CFO, and ad hoc inpatient audits are no longer enough of a defensive strategy.…
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To a compliance officer, the words “corporate integrity agreement” (CIA) can send a chill up and down the spine. When you look at the true meaning and goal of a CIA though, you can see that its intent is not punitive, but instead a road map to make a healthcare…
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Indeed, it was another “Dantastic” Monday as Inspector General Dan Levinson took the podium to deliver the keynote at the 21st Annual Compliance Institute in National Harbor, Maryland.  Dan opened with the discussion of a January Health Care Compliance Association (HCCA) U.S. Department of Health and Human Services Office of…
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On the next edition of Monitor Mondays, Mary Beth Pace, vice president of care management at Trinity Health, will share how her health system is traversing the new compliance landscape of the MOON: the Medicare Outpatient Observation Notice, which became effective March 8. What are they discovering, and how are…
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Who complained?That might seem like a totally reasonable question. But it’s something that compliance officers might want to discourage from being asked. The issue was driven home for me recently when a client in the desert Southwest had an unpleasant interaction with a representative from the local licensing board. The board…
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Early warning signs have revealed that the Centers for Medicare & Medicaid Services (CMS) will soon be launching an audit program for compliance with administrative simplification, according to Monitor Mondays special guest Matthew Albright, former director of the CMS Administrative Simplification Group, now vice president of legislative affairs for Zelis…
February 19, 2017

MedLearn Publishing

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MedLearn Publishing is a nationally recognized healthcare publishing and media firm specializing in all aspects of coding, compliance, reimbursement and the revenue cycle. For more than 25 years, MedLearn Publishing has delivered actionable answers that equip healthcare organizations to confidently meet their revenue and compliance obligations. MedLearn Publishing clients access…
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