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Send us a textIn this episode of the Advancing Surgical Care Podcast, ASCA Chief Executive Officer Bill Prentice talks with Robert Saltaformaggio, senior counsel at Liles Parker, a Washington, DC-based law firm that focuses on regulatory healthcare compliance and reimbursement issues. Saltaformaggio is also a certified professional coder who assists ASCs and other healthcare providers with Medicare and Medicaid payer coverage and payment requirements, as well as claims disputes with major payers such as the various Blue Cross Blue Shield entities and UnitedHealthcare. During their discussion, Prentice and Saltaformaggio talk about the current regulatory landscape, the role of AI, the importance of conducting self-audits and more.
Angela Barker joins host Todd Marquardt to talk about healthcare compliance on this edition of Talk Law Radio. Angela provides proactive audits for Pediatric Home Health Agencies that offer Private Duty Nursing and Therapy. The mission of Talk Law Radio is to help you discover your legal issue blind spots by listening to me talk about the law on the radio. The state bar of Texas is the state agency that governs attorney law licenses. The State Bar wants attorneys to inform the public about the law but does not want us to attempt to solve your individual legal problems upon the basis of general information. Instead, contact an attorney like Todd A. Marquardt at Marquardt Law Firm, P.C. to discuss your specific facts and circumstances of your unique situation. Leave a legacy that makes a positive impact on people's lives Chat online at MarquardtLawFirm.com to schedule an appointment to help you create a legally enforceable last will, living trust, or tax protected inheritance plan. Tell a friend what this show is about discovering hidden legal issue blind spots like in business and estates and elder law. Today's hidden legal issue blind spot is "Citizenship." Subscribe to the Talk Law Radio YouTube channel to watch the show in four separate segments. Like & Subscribe! https://www.youtube.com/@talklawradio3421 Listen here! www.TalkLawRadio.com Work with Todd! https://marquardtlawfirm.com/ Join attorney Todd Marquardt every week for exciting law talk on Talk Law Radio! Follow Shannon Salmon-Haas! Instagram: @shannonrobertasanantonio Tik Tok: @shannonrobertasa Facebook: @Shannon Roberta San Antonio See omnystudio.com/listener for privacy information.
SummaryThe conversation delves into the evolving role of artificial intelligence (AI) in healthcare, particularly its implications for compliance, documentation, and evaluation and management services. The speakers discuss the benefits and challenges of AI, emphasizing the need for providers to understand its limitations and the importance of maintaining accurate documentation. They also explore the complexities of billing for evaluation and management services, highlighting the risks associated with improper documentation and the scrutiny from insurance companies.TakeawaysAI is significantly impacting healthcare, especially in diagnostics.Providers must ensure they understand AI's limitations and capabilities.Compliance and documentation are critical when using AI tools.There are many pitfalls in AI that providers need to be aware of.Patients have the right to opt out of AI-assisted documentation.The importance of accurate documentation cannot be overstated.Modifiers like 25 and 59 are often misused in billing.Commercial payers are becoming more aggressive in audits.Public comments can lead to better regulatory outcomes.Documentation manipulation is a serious concern in healthcare.
In this episode of Compliance Conversations, host CJ Wolfsits down with returning guest Sean McKenna, a Partner at Nelson Mullins and former Federal Prosecutor, to explore the critical issues at the intersection of healthcare law and compliance. From the challenges posed by the False Claims Act to the innovative use of data analytics in enforcement, Sean offers firsthand insights drawn from years of legal practice. Whether you're managing a compliance program or navigating regulatory challenges, this episode delivers actionable strategies and expert predictions for the future. What You'll Learn: - How evolving legal standards impact healthcare providers - The role of whistleblower initiatives in driving compliance - Data analytics as a game-changer in regulatory enforcement - Strategies to build and maintain effective compliance programs - Predictions for upcoming changes in healthcare law and regulation
Join us for an eye-opening conversation on Compliance Conversations, where CJ Wolf interviews Nick Sahar, founder of Semantic Health and pioneer in AI for medical coding. In this episode, you'll learn: - How AI enhances coding accuracy and speeds up workflows. - Practical use cases for AI in coding, auditing, and clinical documentation. - What the future holds for AI in healthcare compliance. Don't miss this must-listen discussion about how technology is shaping the future of healthcare compliance and coding.
Summary In this conversation, Sean discusses the critical issue of healthcare fraud, emphasizing the roles of the Department of Justice and the Office of the Inspector General. He outlines various laws and regulations, shares alarming statistics about fraud losses, and highlights emerging challenges in the healthcare landscape. Sean also explores the impact of technology on fraud detection and prevention, provides real-world case studies, and offers actionable recommendations for healthcare providers to combat fraud effectively. Takeaways The DOJ and OIG are crucial in combating healthcare fraud. Healthcare fraud includes various deceptive practices. Fraud costs the U.S. healthcare system billions annually. Whistleblower claims are increasing in healthcare fraud cases. Telehealth has created new vulnerabilities for fraud. AI and technology are essential tools in fraud detection. Regular training and education are vital for healthcare staff. Collaboration among stakeholders is necessary to combat fraud. Regulatory frameworks must adapt to new challenges. A proactive approach is needed to protect healthcare integrity.
Dive into the transformative world of technology-driven healthcare safety with Amanda Penrod, PhD, MBA, CASC, CEO & Founder of RFX Solutions. In this compelling episode, Amanda addresses the urgent challenges facing healthcare compliance and patient safety, sharing how strategic technology partnerships can be game-changers for healthcare organizations. Discover the key barriers to creating a safety-focused culture and explore actionable strategies and innovative tools to streamline compliance and empower staff management. Gain expert insights on what sets true technology partners apart and learn how to navigate the evolving healthcare landscape confidently.This episode is sponsored by RFX Solutions.
Dive into the transformative world of technology-driven healthcare safety with Amanda Penrod, PhD, MBA, CASC, CEO & Founder of RFX Solutions. In this compelling episode, Amanda addresses the urgent challenges facing healthcare compliance and patient safety, sharing how strategic technology partnerships can be game-changers for healthcare organizations. Discover the key barriers to creating a safety-focused culture and explore actionable strategies and innovative tools to streamline compliance and empower staff management. Gain expert insights on what sets true technology partners apart and learn how to navigate the evolving healthcare landscape confidently.This episode is sponsored by RFX Solutions.
The Emergence of Innovative Partnerships: As AI becomes increasingly integral across industries, healthcare is at the forefront of adopting these technologies to improve patient outcomes and streamline services. Sean Martin emphasizes the collaboration between StackAware and Embold Health, setting the stage for a discussion on how they leverage HITRUST to enhance healthcare solutions.A Look into StackAware and Embold Health: Walter Haydock, founder and CEO of StackAware, shares the company's mission to support AI-driven enterprises in measuring and managing cybersecurity compliance and privacy risks. Meanwhile, Steve Dufour, Chief Security and Privacy Officer of Embold Health, describes their initiative to assess physician performance, guiding patients toward top-performing providers.Integrating AI Responsibly: A key theme throughout the conversation is the responsible integration of generative AI into healthcare. Steve Dufour details how Embold Health developed a virtual assistant using Azure OpenAI, ensuring users receive informed healthcare recommendations without long-term storage of sensitive data.Assessment Through Rigorous Standards: Haydock and Dufour also highlight the importance of ensuring data privacy and compliance with security standards, from conducting penetration tests to implementing HITRUST assessments. Their approach underscores the need to prioritize security throughout product development, rather than as an afterthought.Navigating Risk and Compliance: The conversation touches on risk management and compliance, with both speakers emphasizing the importance of aligning AI initiatives with business objectives and risk tolerance. A strong risk assessment framework is essential for maintaining trust and security in AI-enabled applications.Conclusion: This in-depth discussion not only outlines a responsible approach to incorporating AI into healthcare but also showcases the power of collaboration in driving innovation. Sean Martin concludes with a call to embrace secure, impactful technologies that enhance healthcare services and improve outcomes.Learn more about HITRUST: https://itspm.ag/itsphitwebNote: This story contains promotional content. Learn more.Guests: Walter Haydock, Founder and CEO, StackAwareOn LinkedIn | https://www.linkedin.com/in/walter-haydock/Steve Dufour, Chief Security & Privacy Officer, Embold HealthOn LinkedIn | https://www.linkedin.com/in/swdufour/ResourcesLearn more and catch more stories from HITRUST: https://www.itspmagazine.com/directory/hitrustView all of our HITRUST Collaborate 2024 coverage: https://www.itspmagazine.com/hitrust-collaborate-2024-information-risk-management-and-compliance-event-coverage-frisco-texasAre you interested in telling your story?https://www.itspmagazine.com/telling-your-story
The Emergence of Innovative Partnerships: As AI becomes increasingly integral across industries, healthcare is at the forefront of adopting these technologies to improve patient outcomes and streamline services. Sean Martin emphasizes the collaboration between StackAware and Embold Health, setting the stage for a discussion on how they leverage HITRUST to enhance healthcare solutions.A Look into StackAware and Embold Health: Walter Haydock, founder and CEO of StackAware, shares the company's mission to support AI-driven enterprises in measuring and managing cybersecurity compliance and privacy risks. Meanwhile, Steve Dufour, Chief Security and Privacy Officer of Embold Health, describes their initiative to assess physician performance, guiding patients toward top-performing providers.Integrating AI Responsibly: A key theme throughout the conversation is the responsible integration of generative AI into healthcare. Steve Dufour details how Embold Health developed a virtual assistant using Azure OpenAI, ensuring users receive informed healthcare recommendations without long-term storage of sensitive data.Assessment Through Rigorous Standards: Haydock and Dufour also highlight the importance of ensuring data privacy and compliance with security standards, from conducting penetration tests to implementing HITRUST assessments. Their approach underscores the need to prioritize security throughout product development, rather than as an afterthought.Navigating Risk and Compliance: The conversation touches on risk management and compliance, with both speakers emphasizing the importance of aligning AI initiatives with business objectives and risk tolerance. A strong risk assessment framework is essential for maintaining trust and security in AI-enabled applications.Conclusion: This in-depth discussion not only outlines a responsible approach to incorporating AI into healthcare but also showcases the power of collaboration in driving innovation. Sean Martin concludes with a call to embrace secure, impactful technologies that enhance healthcare services and improve outcomes.Learn more about HITRUST: https://itspm.ag/itsphitwebNote: This story contains promotional content. Learn more.Guests: Walter Haydock, Founder and CEO, StackAwareOn LinkedIn | https://www.linkedin.com/in/walter-haydock/Steve Dufour, Chief Security & Privacy Officer, Embold HealthOn LinkedIn | https://www.linkedin.com/in/swdufour/ResourcesLearn more and catch more stories from HITRUST: https://www.itspmagazine.com/directory/hitrustView all of our HITRUST Collaborate 2024 coverage: https://www.itspmagazine.com/hitrust-collaborate-2024-information-risk-management-and-compliance-event-coverage-frisco-texasAre you interested in telling your story?https://www.itspmagazine.com/telling-your-story
Summary In this conversation, Sean and his guests discuss various pressing issues in healthcare, focusing on the implications of HIPAA violations, the challenges of patient privacy, and the recent controversies surrounding the Epic EMR system. They delve into the complexities of unauthorized access to patient information, the role of AI in healthcare compliance, and the legal ramifications of the recent overturning of the Chevron deference. The discussion highlights the importance of statistical sampling in overpayment estimations and the evolving landscape of healthcare legislation, particularly in light of the False Claims Act. Takeaways Epic EMR's interoperability issues have led to legal challenges. HIPAA compliance is critical in protecting patient information. Unauthorized access to medical records is a growing concern. AI tools in healthcare require careful human oversight. Zero paid claims must be considered in overpayment estimations. The Chevron deference ruling will impact regulatory interpretations. The False Claims Act's provisions are under legal scrutiny. Veterans' support is crucial, especially in times of need. Healthcare professionals must prioritize patient privacy and compliance. The Epic EMR Controversy Explained The Future of the False Claims Act "Epic has not particularly been a company that plays well in the sandbox." "You can't just think that signing a waiver will protect you." Chapters Introduction and Context Setting 02:54 The Epic EMR Controversy 07:53 HIPAA Violations and Patient Privacy 14:59 Unauthorized Access and Compliance Challenges 20:02 The Impact of AI on Healthcare Compliance 24:56 Statistical Sampling and Overpayment Estimation 30:07 The Future of Healthcare Regulations 36:09 Closing Thoughts and Call to Action
Summary In this conversation, Sean and Nicole Thorn discuss the increasing challenges healthcare providers face regarding compliance, particularly in light of rising audit risks and overpayment demands. They explore the complexities of healthcare law, the role of attorneys in navigating disputes, and the importance of proactive compliance strategies. The discussion also touches on the impact of AI in healthcare and the necessity for providers to adapt to these changes while maintaining a culture of compliance. Takeaways Healthcare providers are facing a significant increase in audit risks. The complexity of healthcare law requires specialized legal expertise. Overpayment demands from payers are becoming more aggressive and frequent. Proactive compliance strategies can mitigate risks and improve outcomes. AI is being increasingly utilized by payers to identify potential issues. Effective communication with payers is crucial for dispute resolution. Providers must be prepared to defend their billing practices against audits. The cost of compliance is rising due to increased regulatory scrutiny. Understanding the nuances of payer agreements is essential for providers. A culture of compliance can help providers navigate the challenging healthcare landscape.
Welcome to "Beyond Healthcare Compliance with Joanna Lambert, Director Healthcare Consulting & Advisory," where we delve into the dynamic world of healthcare consulting. In this episode, we introduce you to Joanna Lambert, a healthcare consultant and director at EisnerAmper. She shares her professional journey, detailing her extensive background and experience in the healthcare industry. Discover the critical work she does for healthcare organizations, from improving operational efficiency to strategic planning and financial management. Learn about the top three trends currently shaping the healthcare landscape, and gain insights into her favorite areas of focus within the field. Our director also gives valuable advice on what healthcare organizations should prioritize to achieve financial success in today's challenging environment. Additionally, she highlights the comprehensive services that EisnerAmper's healthcare team offers, designed to support, and elevate healthcare organizations. Join us for an engaging and informative discussion that offers a wealth of knowledge and ability for anyone involved in the healthcare sector.
Send us a textHello listeners, and welcome to this week's episode of Treat Your Business! I'm really excited to be joined by the fabulous Katie Knapton, the new Chair of Physio First. Today, Katie shares why Physio First is such a crucial organisation for physio-led practices. We'll dive into the many ways PhysioFirst supports its members, from sole practitioners to large clinics, and explore the exciting initiatives that are shaping the future of our industry. Whether you're already a member or considering joining, this episode is packed with valuable insights. Let's get started!Episode Summary: In this episode, we sit down with Katie Knapton, Chair of PhysioFirst, to discuss the vital role PhysioFirst plays in supporting physio-led practices. Katie highlights how PhysioFirst is leading the way in providing essential resources, strategic partnerships, and innovative tools that help clinics thrive in a rapidly evolving industry. From CPD opportunities to business support, and even e-commerce solutions, PhysioFirst offers something for everyone. We also explore how the organisation is adapting to meet the challenges of modern practice, including the use of AI and digital innovation.Key Takeaways:Comprehensive Support for All Practice Sizes: PhysioFirst provides tailored resources and support, whether you're a sole practitioner or managing multiple clinics.Innovative Tools and Partnerships: From e-commerce stores to AI integration, PhysioFirst offers cutting-edge solutions to streamline your practice.Importance of Community: Being part of a supportive network of physios helps combat the isolation often felt by clinic owners.Ongoing CPD and Compliance Assistance: PhysioFirst keeps members informed about regulatory updates, making compliance easy and stress-free.Flexible Involvement: Members can engage as much or as little as they like, with opportunities to volunteer and contribute to the community.Call to Action: To get in touch with PhysioFirst, listeners can visit the official PhysioFirst website at www.physiofirst.org.uk. On the website, they can find detailed information about membership benefits, upcoming events, and available resources. Additionally, they can contact the PhysioFirst team directly via email or phone, both of which are provided on the website. For those interested in speaking with a member of the executive team or learning more about specific services, the website also of Resources: BUY YOUR TICKET TO CLINIC GROWTH LIVE https://events.thrive-businesscoaching.com/clinicgrowthlive Join this months FREE masterclass https://join.thrive-businesscoaching.com/masterclass-registration Score App: https://bizhealthcheck.scoreapp.com/ Book a Discovery Call to find out how our programs can help you grow your business https://call.thrive-businesscoaching.com/discovery-call If you've found value in this podcast, I'd greatly appreciate it if you could take a moment to leave a review. Your feedback helps others discover the show and join our community. Thank you for your support!: https://ratethispodcast.com/tyb This podcast is sponsored by HMDG a physiotherapy, Chiropractic, and Allied Health specialist Marketing agency.
Innovation comes in many forms, and compliance professionals must be ready for and embrace it. Join Tom Fox, the Voice of Compliance, as he visits with top innovative minds, thinkers, and creators in the award-winning Innovation in Compliance podcast. In this episode, Tom welcomes compliance aficionado Maria Villanueva to dive deeply into healthcare compliance. In this episode, Tom and Maria discuss her diverse career trajectory from accounting to healthcare compliance and delve into the complexities of ethical selling, aggregate spending challenges, and the growing role of AI in the compliance industry. Drawing on her extensive experience, she offers valuable insights on balancing roles in compliance and HR, the impact of data analytics, and the future landscape of healthcare compliance. Key Highlights Passion for Healthcare Challenges in Healthcare Compliance Balancing Compliance and HR Roles The Role of Data Analytics and AI in Compliance Future of Healthcare Compliance Resources Maria Villanueva on LinkedIn Tom Fox Instagram Facebook YouTube Twitter LinkedIn
Jennifer Geetter, a partner at McDermott, Will and Emery, shares insights on AI and data governance, compliance issues related to AI and privacy, and how state and federal guidance can impact AI innovation in healthcare.00:00 - Introduction01:02 - Jennifer's background and role as a digital health lawyer04:11 - Types of clients / legal needs in digital health09:37 - COVID's impact on healthcare delivery and digital health trends14:41 - Challenges faced by digital therapeutics and the future of digital health19:21 - AI capabilities, regulatory guardrails, and considerations for healthcare companies24:55 - Specific applications of AI in clinical contexts and physician support28:38 - Balancing AI risks and benefits in healthcare33:53 - AI governance, regulatory landscape, and the importance of public trust Jennifer Geetter: https://www.linkedin.com/in/jennifer-geetter-6107406/Chris Hoyd: https://www.linkedin.com/in/chrishoyd/For the full YouTube video: https://youtu.be/l6-F2Stemv0McDermott Will & Emery Website: https://www.mwe.com/ Product in Healthtech is community for healthtech product leaders, by product leaders. For more information, and to sign up for our free webinars, visit www.productinhealthtech.com.
Join Chanie Gluck as she navigates the complex aftermath of the Change Healthcare cyberattack alongside Landon Tooke, COO and Chief Compliance Officer at Impact Healthcare Solutions. In this insightful episode, they discuss the latest developments and strategies for strengthening cybersecurity in the healthcare sector. Show Notes: Chanie sets the stage, discussing her experience and the focus of today's episode—the Change Healthcare cyberattack. Landon, a seasoned healthcare attorney, gives an update on the current situation regarding Change Healthcare, explaining the sequence of events that led to the recent data breaches and the implications for healthcare providers and revenue cycle management (RCM) companies. Detailed breakdown of the cyberattacks by Black Cat, subsequent responses by Change Healthcare, and the emergence of Ransom Hub, a new threat actor claiming possession of sensitive data. Discussion on how the breach has sparked debates over healthcare data security, antitrust concerns, and the potential reevaluation of large healthcare mergers. [Cybersecurity Focus]: Emphasis on the importance of maintaining cybersecurity vigilance, investing in protective measures, and considering cybersecurity insurance as essential parts of healthcare operations. Conclusion: Chanie and Landon reflect on the broader implications of the cyberattack and stress the need for continuous improvement in cybersecurity strategies within the healthcare industry. --- We're thrilled to announce that "Leaders in Medical Billing" has been recognized by Feedspot as one of the Top 15 Medical Billing and Coding Podcasts on the web, currently ranking in 5th place! Learn more about this honor here https://podcasts.feedspot.com/medical_billing_and_coding_podcasts/
The Chat GPT Experiment - Simplifying ChatGPT For Curious Beginners
Opening Paragraph This episode of 'The ChatGPT Experiment' features Jennifer, a healthcare consultant specializing in financial data analysis for medical practices. Host Cary Weston engages Jennifer in a conversation about the practical applications of ChatGPT in healthcare, focusing on streamlining administrative tasks and enhancing communication with various healthcare stakeholders. Main Topics Jennifer's role in healthcare and her approach to integrating financial data with clinical outcomes. Specific use cases of ChatGPT in Jennifer's work, including email drafting, marketing, and conference planning. The conversation at the HIMSS conference regarding AI, legal implications, and data security in healthcare. The potential of AI and ChatGPT to alleviate administrative burdens in healthcare settings. Key Insights/Takeaways ChatGPT serves as a valuable partner for organizing thoughts and managing tasks, particularly for those with administrative and managerial responsibilities in healthcare. The importance of accurate data and human oversight in healthcare, especially concerning patient privacy and compliance. ChatGPT's adaptability to different communication styles and needs, facilitating personalized and efficient interaction with various healthcare professionals. Episode Index: Jennifer's Healthcare Background and Financial Data Analysis [00:00:35] Discussion on Healthcare Compliance and Clinical-Business Connection [00:01:31] Using ChatGPT for Efficiency in Emails and Marketing [00:02:33] Examples of ChatGPT Usage in Conference Planning [00:04:03] Adapting Communication for Different Healthcare Audiences [00:07:30] Insights from HIMSS Conference on Healthcare Automation [00:10:17] Data Privacy and Accuracy Concerns in Healthcare [00:14:28] Balancing Human Input and Technological Efficiency [00:15:59] Jennifer's Use of ChatGPT for Organizing and Project Management [00:23:37] Advice for New Users of ChatGPT in Task Management [00:24:57] Closing Remarks and Jennifer's Podcast [00:28:29] About Jennifer McNamara Jennifer is a healthcare consultant with over 20 years of experience in medical practice management. She specializes in helping healthcare organizations understand their financial data and improve communication between business and clinical sides for the benefit of patients. Jennifer is passionate about compliance and enjoys educating others about the healthcare industry. She recently attended the HIMSS conference, contributing her expertise on the integration of technology and healthcare. Connect with Jennifer: Linkedin: https://www.linkedin.com/in/jennifer-mcnamara-49364586/ Healthcare Inspired Podcast: https://open.spotify.com/show/0w28iXZEdYs701jQSGOB4G?si=gnTZDAJkQW6h1zvKsolS1w ABOUT THE AUTHOR Cary is a seasoned marketing professional and partner in the Bangor, Maine-based advertising and marketing firm Sutherland Weston. He is a certified “They Ask You Answer” coach – a sales and marketing framework developed by Marcus Sheridan designed to help companies stand out as the voice of authority in their industry and drive measurable sales results. His specialties lie in developing practical and tactical strategies to help businesses overcome sales and marketing challenges. Cary is available for coaching, consulting, and strategy engagement with businesses and not-for-profit organizations. Connect with Cary: Podcast Website: www.ChatGPTExperiment.com Cary's Agency Website: www.SutherlandWeston.com LinkedIn: https://www.linkedin.com/in/caryweston LINKEDIN NEWSLETTER The Chat GPT Experiment is also a LinkedIn Newsletter and you can find it here: https://www.linkedin.com/newsletters/the-chat-gpt-experiment-7110348839919702016/ MUSIC CREDITS The instrumental music used in this podcast is called “Curious” by Podington Bear”. You can contact the artist here
“The CAA was the most significant piece of healthcare legislation that we've had since the ACA.” - Sarah Borders Healthcare compliance, especially post-CAA, can be a complex thing for employers to navigate. There's an increased level of scrutiny on employers, with heavy fees for those who don't comply. This week on Self-Funded with Spencer I'm joined by Sarah Borders, co-founder of Benefits Compliance Solutions. Here are a few key takeaways for consultants: Understanding compliance: Navigating the complex regulations and avoid costly mistakes. Turning compliance into an advantage: Discover how you as a consultant can leverage compliance as a prospecting tool, saving clients from lawsuits, penalties, and headaches. Embracing the benefits of regulation: Understand the purpose of the CAA and how it exposes bad practices, ultimately improving healthcare for everyone. Join us this week on Self-Funded with Spencer to learn how to not get sued. Chapters: 0:00 - Meet Sarah Borders 6:37 - Sarah's Journey To Compliance Expertise 14:05 - The Shift Towards Data-Driven Compliance 17:33 - Remote Work As An Entrepreneur 27:01 - Effective Communication = Effective Information 34:57 - Legal Repercussions Of Cobra Compliance 41:34 - Group Health Plan Compliance 46:20 - Yearly Attestation 54:04 - The Impact Of Regulations On Transparency 1:01:21 - Empowering Clients and Consultants 1:04:38 - The Impact Of CAA On Group Health Plans Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words: #insurance #compliance #industrytrends #ACA #caa #levelfundedplans #Cobra #CobraCompliance #grouphealthplan #ConsolidatedAppropriationsAct #attestation #regulations #consulting #futureofcompliance #healthcarecompliance #selffunded #selffunding #podcast Insurance, Compliance, Industry Trends, ACA, CAA, Cobra, Cobra Compliance, Group Health Plan, Consolidated Appropriations Act, Attestation, Regulations, Consulting, Future Of Compliance, Healthcare Compliance, Self Funded, Self Funding, Podcast --- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“The CAA was the most significant piece of healthcare legislation that we've had since the ACA.” - Sarah Borders Healthcare compliance, especially post-CAA, can be a complex thing for employers to navigate. There's an increased level of scrutiny on employers, with heavy fees for those who don't comply. This week on Self-Funded with Spencer I'm joined by Sarah Borders, co-founder of Benefits Compliance Solutions. Here are a few key takeaways for consultants: Understanding compliance: Navigating the complex regulations and avoid costly mistakes. Turning compliance into an advantage: Discover how you as a consultant can leverage compliance as a prospecting tool, saving clients from lawsuits, penalties, and headaches. Embracing the benefits of regulation: Understand the purpose of the CAA and how it exposes bad practices, ultimately improving healthcare for everyone. Join us this week on Self-Funded with Spencer to learn how to not get sued. Chapters: 0:00 - Meet Sarah Borders 6:37 - Sarah's Journey To Compliance Expertise 14:05 - The Shift Towards Data-Driven Compliance 17:33 - Remote Work As An Entrepreneur 27:01 - Effective Communication = Effective Information 34:57 - Legal Repercussions Of Cobra Compliance 41:34 - Group Health Plan Compliance 46:20 - Yearly Attestation 54:04 - The Impact Of Regulations On Transparency 1:01:21 - Empowering Clients and Consultants 1:04:38 - The Impact Of CAA On Group Health Plans Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words: #insurance #compliance #industrytrends #ACA #caa #levelfundedplans #Cobra #CobraCompliance #grouphealthplan #ConsolidatedAppropriationsAct #attestation #regulations #consulting #futureofcompliance #healthcarecompliance #selffunded #selffunding #podcast Insurance, Compliance, Industry Trends, ACA, CAA, Cobra, Cobra Compliance, Group Health Plan, Consolidated Appropriations Act, Attestation, Regulations, Consulting, Future Of Compliance, Healthcare Compliance, Self Funded, Self Funding, Podcast --- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
The Rethinking Compliance series with MedTrainer is officially available, unlocking a wealth of insights into healthcare compliance and innovative solutions to navigate the ever-evolving landscape. In this episode, Saul Marquez presents the main takeaways of the five engaging episodes from the series with MedTrainer that spotlight key compliance aspects and how technology transforms this critical healthcare landscape. Episode one features Steve Gallion, emphasizing the pivotal role of technology in cultivating a culture of compliance. Saul underscores Steve's journey from founding a medical waste company to revolutionizing healthcare compliance with MedTrainer's advanced platform. Dr. Hira Rashid takes the stage in episode two, shedding light on policy and compliance in healthcare. She delves into federal training, data collection, and regulatory adherence, offering valuable insights on staying ahead in an ever-evolving healthcare environment. Brent Althoff joins the conversation in episode three, unveiling the intricacies of healthcare credentialing and its profound impact on compliance and revenue cycles. Episode four explores the symbiotic relationship between technology, compliance, and operations, featuring Kevin Stineman's two decades of expertise. The series concludes with Brian Williams in the fifth episode, exploring the three dimensions of compliance—people, process, and infrastructure. Tune in and learn more about reshaping compliance, enriching understanding, and gaining tools to navigate the dynamic realm of healthcare Resources: Learn more about MedTrainer on their LinkedIn and on their website here. Listen to the entire Rethinking Compliance series here. Episode 1: Steve Gaillon - Understanding the Intersection of Technology and Compliance here. Episode 2: Dr. Hira Rashid - The Impact of Health Policy on Your Compliance Strategy here. Episode 3: Brent Althoff - Protecting the Revenue Cycle With Credentialing here. Episode 4: Kevin Stineman - Technology in Healthcare: Stop Trying To Do it All Right Now here. Episode 5: Brian Williams - Compliance Isn't Just the Policy here.
Christian Okeke Christian Okeke is Information Technology Coordinator at Healing Hands Healthcare with years of experience spanning healthcare, government, and other industries. At Healing Hands, Christian oversees IT strategy and HIPAA compliance. He focuses on understanding business needs, communicating effectively across teams, and implementing technologies to drive productivity. Christian is passionate about continuous learning and...
In der heutigen Folge geht es um die Brennpunkte der Healthcare-Compliance, die Herr Dr. Christian Rosinus gemeinsam mit unserm Gast Herrn Rechtsanwalt Prof. Dr. jur. Hendrik Schneider bespricht. Nach einer kurzen Vorstellung berichtet Herr Prof. Schneider von seiner Mitwirkung am Gesetzgebungsverfahren zu den Tatbeständen der Bestechlichkeit und Bestechung im Gesundheitswesen. Anschließend gibt er im Gespräch mit Herrn Dr. Rosinus einen Überblick über die unterschiedlichen Bereiche der (strafrechtlichen) Healthcare-Compliance. Anhand verschiedener Beispielsfälle erläutern Herr Dr. Rosinus und Herr Prof. Schneider die relevantesten Konstellationen der Korruption im Gesundheitswesen. Daran anknüpfend gibt Herr Prof. Schneider einen Ausblick auf zu erwartende Reformen und Diskussionen im Bereich der Healthcare-Compliance, die sich u.a. aus der fortschreitenden Digitalisierung und dem zunehmenden Einsatz von künstlicher Intelligenz im Gesundheitswesen ergeben. Im Anschluss beleuchten die Gesprächspartner die praktische Relevanz des Abrechnungsbetrugs und dessen Verknüpfungen zum Sozialrecht. Abschließend gibt Herr Prof. Schneider konkrete Compliance-Tipps für Kliniken. Dr. Rosinus im Gespräch mit: Prof. Dr. Hendrik Schneider ist Rechtsanwalt und Kanzleigründer in Wiesbaden. Nach Studium, Promotion und Referendariat im Mainz habilitierte er sich 2003 für Strafrecht, Strafprozessrecht, Kriminologie, Jugendstrafrecht und Strafvollzugsrecht. 2006 wurde er an der Universität Leipzig zum ordentlichen Professor ernannt. Während seiner Tätigkeit als Professor war er bereits als Verteidiger tätig. 2020 machte er sich als Rechtsanwalt selbstständig und berät seitdem Mandaten zu allen Fragen des Wirtschaftsstrafrechts mit einem besonderen Schwerpunkt im Medizinstrafrecht. Prof. Dr. Hendrik Schneider ist erreichbar unter: info@hendrikschneider.eu Website der Kanzlei für Wirtschafts- und Medizinstrafrecht Prof. Dr. Hendrik Schneider: https://hendrikschneider.eu/ https://www.rosinus-on-air.com https://rosinus-partner.com
The Brainy Business | Understanding the Psychology of Why People Buy | Behavioral Economics
Eden Brownell, director of behavioral science at MPulse Mobile, joins Melina Palmer on The Brainy Business podcast to discuss the application of behavioral science in healthcare delivery. The conversation, which was conducted live at Greenbook's IIEX North America conference, delves into the use of behavioral interventions to drive behavior change in healthcare. Brownell shares two case studies that highlight the power of storytelling, social influence, and understanding user experience to improve patient engagement and outcomes. From using videos to simulate the consequences of non-compliance to leveraging loss aversion, the episode demonstrates the effectiveness of behavioral design in healthcare. Brownell emphasizes the importance of addressing real barriers to behavior change and tailoring interventions to the specific needs and motivations of the target audience. Everyone interested in implementing evidence-based behavioral strategies to improve engagement and behavior change will find this episode insightful and practical (it's not just for the healthcare industry). Delve into the cutting-edge fusion of behavioral science and healthcare, and its role in optimizing patient results. Learn about the intriguing complexities of healthcare compliance and the psychology behind procrastination and time discounting. Be intrigued by real-world examples of how behavioral science can massively up the ante when it comes to adherence of medical tests. Discover the transformative power of personalized interventions in enhancing health outcomes with the aid of technology. Understand the synergy between behavioral science and healthcare as a pivotal solution to overcoming prevalent health barriers. Show Notes: 00:00:00 - Introduction, Melina Palmer introduces the podcast episode and welcomes Eden Brownell, the Director of Behavioral Science at MPulse Mobile. This episode is a replay of the live podcast interview conducted at Greenbook's IIEX North America conference. 00:03:24 - Getting to Know Eden Brownell, Eden shares her background and how she got into the field of behavioral science, drawing on her love for understanding human behavior and psychology. 00:06:35 - The Intersection of Theater and Behavioral Science, Eden discusses how her background in theater research has influenced her love for research and understanding human behavior. 00:08:57 - The Challenges of Healthcare Compliance, Melina and Eden explore the issue of compliance in healthcare and how behavioral science can help address it. They discuss the concept of present bias and its impact on healthcare decisions. 00:12:07 - Overcoming the Say-Do Gap, The conversation dives into the say-do gap and the challenges of committing to future actions. Eden shares a case study on healthcare compliance and how behavioral science can be applied to improve outcomes. 00:15:26 - Overcoming Engagement Challenges, Eden discusses the challenges of getting people to engage with colon test kits and the importance of getting their attention. They conducted an A/B test using behavioral science messaging to create a sense of ownership (leveraging loss aversion) and found a significant increase in engagement. 00:17:33 - The Endowment Effect and Psychological Barriers, The endowment effect is discussed as a psychological factor that increases the value of something once it is owned. The guest explains how reframing the message to create a sense of ownership can overcome psychological barriers and increase the likelihood of engagement. 00:19:15 - Increasing Engagement with Colon Test Kits, The results of the A/B test showed a 10-15% increase in engagement when using behavioral science messaging and the endowment effect. Eden discusses the importance of addressing barriers and lowering the perceived effort for members to complete the test. 00:20:44 - Next Steps: Completing the Colon Test Kits, The next step is to focus on increasing completion rates for those who have opted in to receive the test kit. Eden discusses using AI and natural language processing to identify barriers and provide resources to overcome them. 00:26:22 - Using AI to Overcome Barriers, AI is used to identify common barriers mentioned by members and provide targeted responses. Eden emphasizes the importance of allowing barriers to be uncovered and addressing them in real time to increase engagement. 00:30:13 - Encouraging Behavior Change, Eden discusses the importance of using nudges and partitions to encourage people to opt in for important activities such as cancer screenings. She emphasizes the need to make the process simple and streamlined while highlighting the value of health care and preventing cancer. 00:31:29 - Successful Storytelling with Video, Eden shares a passion project that involved using video to promote diabetic eye screening. By utilizing loss aversion and creating an emotional impact, the video successfully increased the click rates for scheduling eye exams by over 200%. 00:35:01 - Using Emotion and Storytelling, Eden discusses the power of emotion and storytelling in driving behavior change. By creating videos that evoke strong emotions and resonate with the audience, it becomes easier to connect people to their future selves and encourage them to take action. 00:39:10 - Leveraging Self-Determination Theory, Eden talks about the impact of self-determination theory and social proof in healthcare. By providing real-life experiences and engaging content, such as videos of moms sharing their concerns and experiences, it becomes easier to spark engagement and provide valuable information to individuals. 00:42:19 - Simplifying the Experience, Eden emphasizes the importance of simplifying the experience for individuals. By reducing complexity and perceived effort, it becomes easier to encourage behavior change and make the overall experience more enjoyable and engaging. Examples include incorporating moments of sunshine and removing unnecessary friction. 00:45:50 - Boosting Engagement and Motivation, The discussion focuses on using social aspects and storytelling to drive engagement and motivation in healthcare. By sharing stories and creating content that can be shared with friends and family, healthcare providers can have a bigger impact on the health and well-being of their members. 00:46:51 - Presenting Health Plans to Prioritize Health, Health plans are often focused on making money, but there is an opportunity to push them to prioritize the healthcare of their members. By testing ideas like sharing messages and content that can be easily shared on social media, health plans can have a broader impact on the health of their members and their extended group. 00:47:33 - Messaging and Social Proof, The conversation highlights the importance of messaging and social proof in healthcare. Simply stating statistics like "one in four women will get breast cancer" may not have the desired impact because people often think they won't be the one affected. Finding ways to effectively communicate and simplify these statistics using images and videos is crucial. 00:48:14 - Simplifying Healthcare Information, The discussion emphasizes the need to simplify healthcare information, especially considering low literacy levels and health literacy levels. Using images, videos, and infographics can help bridge the literacy gap and make healthcare information more understandable and accessible. 00:49:16 - Conclusion, Melina's top insights from the conversation. What stuck with you while listening to the episode? What are you going to try? Come share it with Melina on social media -- you'll find her as @thebrainybiz everywhere and as Melina Palmer on LinkedIn. Thanks for listening. Don't forget to subscribe on Apple Podcasts or Android. If you like what you heard, please leave a review on iTunes and share what you liked about the show. I hope you love everything recommended via The Brainy Business! Everything was independently reviewed and selected by me, Melina Palmer. So you know, as an Amazon Associate I earn from qualifying purchases. That means if you decide to shop from the links on this page (via Amazon or others), The Brainy Business may collect a share of sales or other compensation. Let's connect: Melina@TheBrainyBusiness.com The Brainy Business® on Facebook The Brainy Business on Twitter The Brainy Business on Instagram The Brainy Business on LinkedIn Melina on LinkedIn The Brainy Business on Youtube Learn and Support The Brainy Business: Check out and get your copies of Melina's Books. Get the Books Mentioned on (or related to) this Episode: Engaged, by Amy Bucher Friction, by Roger Dooley Behavioral Science in the Wild, by Dilip Soman and Nina Mazar What Your Customer Wants and Can't Tell You, by Melina Palmer Designing for Behavior Change, by Stephen Wendel Connect with Eden: Follow Eden on LinkedIn MPulse Mobile Top Recommended Next Episode: Engaged, with Amy Bucher (ep 164) Already Heard That One? Try These: Loss Aversion (ep 316) Influence Is Your Superpower, with Zoe Chance (ep 308) You Have More Influence Than You Think, with Vanessa Bohns (ep 197) The Life-Saving Skill of Story, with Michelle Auerbach (ep 288) Behavioral Storytelling, with David Paull (ep 289) Non-Obvious Thinking, with Rohit Bhargava (ep 297) Priming (ep 252) Framing (ep 296) Endowment Effect (ep 139) NUDGES and Choice Architecture (ep 35) Social Proof (ep 87) Partitioning (ep 254) Using Semiotics in Retail, with Rachel Lawes (ep 191) Behavior Change at WW and Beyond (ep 98) Behavioral Science Testing In Real Businesses (ep 94) Behavioral Science in the Wild, with Dilip Soman (ep 241) Designing for Behavior Change with Stephen Wendel (ep 116) Other Important Links: Brainy Bites - Melina's LinkedIn Newsletter
In this eye-opening episode of Corruption, Crime and Compliance, Michael Volkov takes a deep dive into the world of healthcare compliance and fraud. He explores the history, the transformation, and the unique challenges of healthcare compliance. He also sheds light on the alarming rate of fraud in the healthcare industry and the efforts to combat it.You'll hear him discuss:Compliance in healthcare traces back to the 1990s. Its rise is largely due to aggressive federal enforcement programs and increasing regulation.Four significant trends in healthcare compliance include: Rising consumer demand, escalating prices, and increasing regulation during the era of HMO controversies.The DOJ's use of criminal tools and prosecutions to combat healthcare fraud and circumvent government regulations.The growing importance of the False Claims Act as an enforcement tool.The establishment of a robust regulatory enforcement regime through the Center for Medicare Services and the HHS-OIG.As the healthcare industry comes increasingly under federal government regulation and control, the risks of healthcare fraud are escalating. Despite the development of proactive compliance programs, the industry struggles to keep pace with the level of fraud, waste, and abuse.Beyond the traditional elements of compliance programs, the healthcare industry faces unique challenges. These include managing interactions with physicians, ensuring data privacy, avoiding the employment of ineligible persons, and navigating the complexities of billing, coding, and overpayments.The False Claims Act poses a significant risk for healthcare providers, with nearly 99% of all cases each year immediately settled. The Act has been applied beyond billing and reimbursement issues to include false representations incorporated into a product or a drug.The DOJ regularly conducts nationwide crackdowns on healthcare fraud, arresting numerous defendants involved in healthcare fraud and opioid abuse schemes. A growing area of concern is telemedicine fraud, which has seen a surge with the rise of remote work during the pandemic.KEY QUOTES:“Healthcare is becoming increasingly under federal government regulation and control. And as this occurs, the federal health care risks of fraud are going to be increasing significantly. Private insurance companies are also experiencing continuous growth of fraud and the healthcare industry is really developing proactive compliance programs, but they struggle to keep up with the level of fraud, waste and abuse that they sort of have to pursue.” - Michael Volkov“…one of the most significant risk areas is physician interactions.” - Michael Vokov“Nearly 99% of all False Claims Act cases each year where the government decides to intervene are immediately settled.” - Michael VolkovResourcesMichael Volkov on LinkedIn | TwitterThe Volkov Law Group
Welcome to Recruitment Down Under.In this podcast, APSCo Australia's Lesley Horsburgh talks with Benjamin Lepke about HealthPass, a newly created platform to collect data from candidates across the complex world of medical and health.The platform reduces the administrative burden required to work across different geographies and workplaces, and is revolutionising the way medical and health candidates are connecting with recruitment businesses.There's even scope for other recruitment sectors to utilise the technology.Please join us to hear how it's progressing, and where it's all headed.Thank you for listening to Recruitment Down Under.
With almost a decade's worth of hands-on #legal experience, Bethany Corbin (Senior Counsel at Nixon Gwilt Law) empowers pioneering femtech and healthcare innovation companies to achieve their goals with well-crafted legal counsel and strategic guidance. In particular, she advises healthcare and pharmaceutical clients, including #femtech, digital health, Medtech, life sciences, and virtual care #businesses, on matters relating to privacy, security, regulatory compliance, reimbursement, and customer and partner transactions. Armed with a #Healthcare LL.M. from Loyola University Chicago School of Law, a J.D. from Wake Forest University School of Law, and certifications in Healthcare Compliance, Healthcare Privacy Compliance, and Information Privacy (CIPP/US), Bethany partners with emerging digital health companies on the forefront of healthcare transformation to ensure that they are building robust, scalable, and legally-compliant companies that are ready to lead the industry. Her experience as a former big law attorney, federal appellate clerk, and law school professor uniquely positions her to guide health innovation companies along their journey from small startup to global public company. Bethany regularly writes and speaks on the intersection of health and technology, and on the ethical and legal implications of femtech within a national and global context. Her publications include co-editing a healthcare contract drafting book, peer-reviewed articles, Law Review articles, industry publications, and blog posts. She also hosts the Legally Femtech podcast, which provides practical, ethical, and legal insights to the femtech community. http://feminnovation.com Hosted on Acast. See acast.com/privacy for more information.
What do you get when two attorneys and a compliance expert sit down for a chat? This episode of Compliance Conversations! Tune in to our conversation with Sean McKenna, a partner in Spencer Fane LLP's Dallas office, and Keith Dugger, a shareholder in Hall Render's Dallas office. Sean and Keith bring unique perspectives to our discussion filled with insights and tips for healthcare compliance professionals.
What do the housing, automotive, technology, and healthcare industries all have in common? Compliance programs and professionals! Borrowing best practices from other businesses is a vital strategy for evolving healthcare compliance programs. That's why we invited Asha Muldro of Guidepost Solutions to chat with us for our latest episode of Compliance Conversations. Tune in today!
What is the one thing you can do to better grow your healthcare business? Marc Haskelson, President and CEO of Compliancy Group, argues that meeting compliance standards is not just about meeting legal requirements. Meeting compliance standards help you serve your clients better, give better tools to your staff, and increase profitability by 15%. Compliance is no longer a “big business” requirement, so tune in and hear what you need to know to realize the benefits of compliance.
Suganya Karuppana, MD, MHCD, CPE, CHC, CHPQ, Chief Medical Officer at Valle del Sol, talks about the shortage of mental health professionals in Arizona and what's being done about it. We discuss the continued integration of behavioral health and primary care. Dr. Karuppana shares some tips for physicians considering the integration process. Dr. Karuppana is a Board-Certified Family Physician with 20 years of experience in healthcare. She attended Cornell University for her Bachelor of Science degree in Human Biology, Health, and Society and Albany Medical College for her Doctor of Medicine. She completed a Family Medicine Residency and Faculty Development Fellowship at Harbor-UCLA Medical Center in Los Angeles, and a Master of Science degree in the science of health care delivery from Arizona State University. She is a Certified Physician Executive, Certified Professional in Healthcare Quality, and Certified in Healthcare Compliance. Hosted and produced by John McElligott. Arizona Physician magazine and podcast are brought to you by Maricopa County Medical Society. This episode is sponsored by Bahbah Sobers Wealth Management and FirstNet, built with AT&T.
Marketing operations is different in every industry. That's no less true for healthcare, a space notorious for stringent conditions on compliance. Of course, that adds a very important layer to consider when developing a robust strategy. Good thing there are people like Mark Clark, Senior Manager Marketing Operations at Indivior, who get the value of cross-collaboration and breaking down barriers within a company. Mark has been in the sales field, marketing, and marketing operations his whole career. But he's also worked in compliance-heavy industries that whole time, making him uniquely qualified to bring all parties to the table to mitigate risk in profound ways. Join us as we discuss: Developing a “big picture” mindset for the whole company The intersection of risk management, revenue, and operations Managing the evolving field of marketing operations
The Medcurity Podcast: Security | Compliance | Technology | Healthcare
Take a listen to Medcurity's CEO Joe Gellatly and DNSFilter's Sr. Director of DSDI, Rebecca Gazda, for a conversation about Healthcare Compliance, Cybersecurity, and how to bridge both to better protect your patients' data.
Bom dia, boa tarde, boa noite! SBA Podcast e a Sociedade Brasileira de Anestesiologia com você. Por este canal, trazemos informações, dicas, entrevistas e novidades sobre nossa saúde ocupacional, valorizamos a defesa profissional e aprimoramos a qualidade e segurança da medicina perioperatória. Eu sou o Pablo Gusman, médico anestesiologista e podcaster do Medicina do Conhecimento. A sociedade muda de forma alucinante com tanta tecnologia e informação, mas valores éticos apesar de se transformarem, o fazem lentamente e precisam de décadas para enraizar novos preceitos. Importante discutir esse tema, bioética, em um mundo tão vibrante! Eu, Pablo Gusman e nosso diretor de defesa profissional, Dr Luiz Antonio dos Santos Diego, conversamos com Dra Camila Kitazawa Cortez, advogada, especialista em bioética, direito médico e healthcare compliance. Mestranda em ciências da saúde, é fundadora da KCortez Consultoria e Assessoria de Direito Medico, Bioética e Healthcare Compliance. Para entrar em contato, use o email camila@kcortez.com.br e siga no instagram @camilacortez No mundo cada vez mais vibrante e repleto de oportunidades, você precisa de uma fonte segura de informações, respaldada por renomados e conhecidos profissionais. Vamos lá! Ative a notificação para ser informado quando um novo SBA podcast for publicado. Estamos no Soundcloud, Spotify, Deezer, Apple e Google Podcast! Deixe seu like, seu jóia e sua curtida onde escutar. Compartilhe com seus contatos, mande seu comentário! Escute também o SBA podcast direto no site www.sbahq.org Essa é uma parceria da Sociedade Brasileira de Anestesiologia e o Medicina do Conhecimento, afinal, compartilhar é multiplicar!
“The Godfather” of corporate governance and compliance joined Sean to discuss the False Claims Act, Regulatory Compliance Matters and what healthcare professionals should be aware of to avoid unwanted legal entanglements. As the Deputy Chief Counsel, Office of the General Counsel, United States Department of Health and Human Services, Dallas, Texas, Gabriel advised and represented various agencies of the Department of Health and Human Services, including the Center for Medicare and Medicaid Services, the Public Health Service, the Social Security Administration, and the Office of the Inspector General. Gabriel's personal practice includes representing individuals and organizations accused of healthcare fraud and assisting and advising healthcare organizations on corporate governance and compliance matters. Gabriel is board certified as a specialist in Health Law by the Florida Bar. Gabriel is a graduate of DePaul University College of Law and the University of Massachusetts. He is also certified in Health Care Compliance (CHC) by the Society of Corporate Compliance and Ethics and the Health Care Compliance Association (SCCE/HCCA). This national accreditation reflects a professional level of competence and experience in compliance processes sufficient to assist healthcare business organizations to understand and address legal obligations and to promote organizational governance and integrity through the operation of effective compliance programs. Gabriel's specific practice areas include Federal Government Strategies, Healthcare Compliance & Operations, Healthcare Government Investigations & Litigation, Healthcare Qui Tam Investigations & Litigation, State & Local Government Relations, and HIPAA & Health Information Privacy & Security.
Billions of people are now fully dependent on various forms of technology as part of their daily lives. Healthcare is no exception. As paper forms give way to digital health records and electronic communications, the risks of losing control of private patient information has risen dramatically. Every organization that deals with healthcare data must come to grips with an increasingly challenging landscape of criminal sophistication and the constant flow of new regulations that are being put in place by international, federal, and local authorities. In this episode, Greg Kefer is joined by Justin Wiley, Director of Information Security and Compliance at Lifelink Systems, to discuss the current state of compliance in healthcare IT. For any company that is involved in buying, selling, or delivering technology in healthcare, a sound approach to security and compliance has become table stakes. The industry can't stand still. Digital innovation is more important than ever, but there are ways to ensure the technology being put in place has been vetted. Justin describes SOC 2, one of the “gold standard” audits, that dives deeply into technology organizations and how they operate, helping ensure best practices are in place and followed.
Billions of people are now fully dependent on various forms of technology as part of their daily lives. Healthcare is no exception. As paper forms give way to digital health records and electronic communications, the risks of losing control of private patient information has risen dramatically. Every organization that deals with healthcare data must come to grips with an increasingly challenging landscape of criminal sophistication and the constant flow of new regulations that are being put in place by international, federal, and local authorities. In this episode, Greg Kefer is joined by Justin Wiley, Director of Information Security and Compliance at Lifelink Systems, to discuss the current state of compliance in healthcare IT. For any company that is involved in buying, selling, or delivering technology in healthcare, a sound approach to security and compliance has become table stakes. The industry can't stand still. Digital innovation is more important than ever, but there are ways to ensure the technology being put in place has been vetted. Justin describes SOC 2, one of the “gold standard” audits, that dives deeply into technology organizations and how they operate, helping ensure best practices are in place and followed.
In this episode, Christine continues on compliance and how to implement the seven elements of an effective compliance program.
In this episode, Christine goes over the importance of a Compliance Program.Helpful Links: CMS 2022 MPFS Final Rule - https://www.govinfo.gov/content/pkg/FR-2021-11-19/pdf/2021-23972.pdf OIG Work Plan Action Items - https://oig.hhs.gov/reports-and-publications/workplan/active-item-table.asp
In this episode, you'll learn how AI is used to reduce compliance risks and inform the FDA about adverse events.
Welcome to the Healthcare Compliance Insights podcast, a series focused on healthcare regulatory, revenue integrity, compliance, and risk management topics. In this episode, BerryDunn healthcare consultants Regina Alexander and Cheryl Gregory discuss the oversight responsibilities of healthcare organization Boards and the role of an active and engaged Board of Directors within an effective compliance program.
Post By: Adam Turteltaub At the 2022 HCCA Compliance Institute, Tonja Wise (LinkedIn), Corporate Director of Compliance, Sharp HealthCare will be leading a session “Your Audit Plan is on Point…but How is Your Moderating Game?” It's a very good question, and in this podcast she offers very helpful advice on how to improve your monitoring efforts. First, since monitoring and auditing are often referred to together as if they are the same thing, she defines the difference between the two. Monitoring, she explains, tend to come after a problem, or potential one, is identified and there is a need to ensure that the remediation in place is working. Like other areas of compliance she advises a risk-based approach. Health care entities should focus on areas of recent government audits or any place they already have a correction plan in place. Avoid focusing on areas where the risk is low of either an incident or having to pay a substantial penalty. To have a strong monitoring program in place, Tonja explains, you need an experienced staff and the right software. An Excel spreadsheet to track things is probably not enough. Listen in to learn more about how to effectively monitor your healthcare compliance program, and then join us for the 2022 HCCA Compliance Institute.
Post By: Adam Turteltaub At the 2022 HCCA Compliance Institute, Tonja Wise (LinkedIn), Corporate Director of Compliance, Sharp HealthCare will be leading a session “Your Audit Plan is on Point…but How is Your Moderating Game?” It's a very good question, and in this podcast she offers very helpful advice on how to improve your monitoring efforts. First, since monitoring and auditing are often referred to together as if they are the same thing, she defines the difference between the two. Monitoring, she explains, tend to come after a problem, or potential one, is identified and there is a need to ensure that the remediation in place is working. Like other areas of compliance she advises a risk-based approach. Health care entities should focus on areas of recent government audits or any place they already have a correction plan in place. Avoid focusing on areas where the risk is low of either an incident or having to pay a substantial penalty. To have a strong monitoring program in place, Tonja explains, you need an experienced staff and the right software. An Excel spreadsheet to track things is probably not enough. Listen in to learn more about how to effectively monitor your healthcare compliance program, and then join us for the 2022 HCCA Compliance Institute.
Post By: Adam Turteltaub There are a lot of good reasons to do a periodic review of your healthcare compliance program, not the least of which is that the government expects it. But when's the right time? How do you get the management support? What outside experts do you need? And how do you integrate the results into your workplan? Those questions are tackled by Anne Daly, Vice President of Compliance, Samaritan health System, Judy A. Ringholz, Vice President of Compliance and Ethics & Chief Compliance Officer, Jackson Health System and Steven W. Ortquist, Founder & Principal, Arete Compliance Solutions in this podcast and at their session “How to Assure that Your Next Compliance Program Review Confirms Performance and Helps Improve Your Compliance Program” at the 2022 HCCA Compliance Institute. It's important, they explain, to make sure that you have your arms around the program before you begin the review. If you're new to the role, you probably don't know enough about the program to make the review as successful as it could be. Once you feel that you are ready and that it's time to have outside eyes review the program, it's important to select a vendor with healthcare-specific experience, ideally with experience interacting with enforcement. Make sure they also have a solid understanding of the government's expectations as well as your organization's goals. Be sure they also are well versed in the fiduciary duties of healthcare boards and have the personal presence to be able to present to the board. One thing else to do: make sure the consultant is reasonable. You want someone who will give you actionable recommendations, not someone caught up in a quest for perfection. Be prepared to dedicate significant staff resources to help the review, most likely including a dedicated person who will be on point for the project. A consultant is going to need your team to provide a lot of documents about the program and assistance in scheduling interviews with key employees. Once the work is done and the report is drafted, it's a good idea to review it with the consultant to make sure that he or she truly understands the organization and didn't misinterpret any information. Be sure also to meet with the board and key leadership so that they understand the purpose and benefits of the review, including that it is a part of their fiduciary duty to have an effective compliance program. And, be sure to bring your workplan to the final presentation to the board. That's an ideal time to both demonstrate what you plan on doing and ask for the resources you need to get the job done. Listen in to learn more, and then join us in Phoenix (in person or virtually) March 28-31 for the 2022 HCCA Compliance Institute.
Post By: Adam Turteltaub There are a lot of good reasons to do a periodic review of your healthcare compliance program, not the least of which is that the government expects it. But when's the right time? How do you get the management support? What outside experts do you need? And how do you integrate the results into your workplan? Those questions are tackled by Anne Daly, Vice President of Compliance, Samaritan health System, Judy A. Ringholz, Vice President of Compliance and Ethics & Chief Compliance Officer, Jackson Health System and Steven W. Ortquist, Founder & Principal, Arete Compliance Solutions in this podcast and at their session “How to Assure that Your Next Compliance Program Review Confirms Performance and Helps Improve Your Compliance Program” at the 2022 HCCA Compliance Institute. It's important, they explain, to make sure that you have your arms around the program before you begin the review. If you're new to the role, you probably don't know enough about the program to make the review as successful as it could be. Once you feel that you are ready and that it's time to have outside eyes review the program, it's important to select a vendor with healthcare-specific experience, ideally with experience interacting with enforcement. Make sure they also have a solid understanding of the government's expectations as well as your organization's goals. Be sure they also are well versed in the fiduciary duties of healthcare boards and have the personal presence to be able to present to the board. One thing else to do: make sure the consultant is reasonable. You want someone who will give you actionable recommendations, not someone caught up in a quest for perfection. Be prepared to dedicate significant staff resources to help the review, most likely including a dedicated person who will be on point for the project. A consultant is going to need your team to provide a lot of documents about the program and assistance in scheduling interviews with key employees. Once the work is done and the report is drafted, it's a good idea to review it with the consultant to make sure that he or she truly understands the organization and didn't misinterpret any information. Be sure also to meet with the board and key leadership so that they understand the purpose and benefits of the review, including that it is a part of their fiduciary duty to have an effective compliance program. And, be sure to bring your workplan to the final presentation to the board. That's an ideal time to both demonstrate what you plan on doing and ask for the resources you need to get the job done. Listen in to learn more, and then join us in Phoenix (in person or virtually) March 28-31 for the 2022 HCCA Compliance Institute.
This episode features David Sclar, Healthcare Compliance and Privacy Officer and Author of “Workplace Strategies for Technology Lawyers”. Here, he discusses his focus on technology companies, his book, and more.
This episode features David Sclar, Healthcare Compliance and Privacy Officer and Author of “Workplace Strategies for Technology Lawyers”. Here, he discusses his focus on technology companies, his book, and more.
Mr. Ron Chapman II began his career as an officer in the U.S. Marine Corps and was deployed to combat in Afghanistan. He achieved the rank of Captain before transitioning to law. He graduated from Loyola School of Law, where he received his Master of Laws (LL.M.) with a concentration in health care compliance. He quickly established himself as a premier healthcare defense counsel, and is among the few attorneys to have achieved trial acquittals on behalf of clients charged with healthcare financial fraud or improper opioid prescribing.
In this second episode of a Perkins Coie White Collar & Investigations series regarding False Claims Act (FCA) enforcement, firm attorneys Barak Cohen and Alex Canizares are joined by their guest, Pete Jensen, global chief compliance officer for Arthrex, Inc., one of the world's largest medical device companies. In the podcast, Pete discusses the myriad challenges healthcare companies face when managing compliance risks, including related to whistleblowers. Barak, Alex, and Pete also discuss how current enforcement positions by the U.S. Department of Justice are especially troubling given the densely regulated muddle of law, sub-regulatory guidance, and policies that compliant healthcare companies must navigate.
Christian Perez Font, Managing Director of Thinkeen Legal, specializes in using data to help clients do traditional legal tasks. The legal department is a business support function, he tells host Tom Fox. He is licensed as an attorney in Venezuela and the USA, and opened Thinkeen Legal in 2018 to provide his clients with “business advice with legal content”, particularly in corporate, transactional, and compliance matters. In this episode of the ESG Report, Christian discusses with Tom about how ESG impacts the healthcare, energy, and the M&A space. Healthcare Compliance & ESG Many healthcare companies donate to community initiatives and are often asked to contribute to social responsibility efforts. However, the healthcare space has specific compliance regulations, such as the anti-kickback statute which prohibits payment for referrals. These regulations are being enforced more strictly. How you set up your compliance program is so important, Christian tells Tom. You should have policies and separate structures for dealing with charitable contributions so that they can be audited and the data analyzed. He describes how he helps clients formulate an ESG program that incorporates modern concepts. Energy Compliance & ESG Tom remarks on Venezuela's social responsibility requirement for energy companies that was in place long before ESG became a trend. It was one of the first countries to mandate such measures, Christian agrees; the aim was for international companies to contribute to local communities. Personally, Christian does not like these mandates: he prefers companies to contribute voluntarily because it's the right thing to do and because they want to get involved. “My philosophy in compliance has always been that we need to move the needle from compliance to ethics, where we do the right thing not because we're obligated to do it, but because we think it's the right thing to do,” he comments. Tom asks, “How do we do this in the ESG, and then how do we document and report it to those ESG stakeholders who might be interested?” There's no clear answer about who is best qualified to lead ESG in an organization, Christian responds, but somebody needs to do it. “Somebody needs to be tracking what the company's doing in terms of ESG and not only tracking but helping visualize it so that everybody can understand…” M&A & ESG “Are you beginning to have discussions with clients about looking at testing or performing due diligence on ESG components of [M&A] targets?” Tom asks Christian. ESG is becoming a bigger part of the conversation, especially with younger investors, Christian responds. Your reputation as a business will play a big part in whether you can attract investors. They also want to see your commitment to social responsibility, governance, and transparency, all of which are ESG issues. Resources Christian Perez Font on LinkedIn Thinkeen Legal | Email
Guest: Dave Klein, CPC, CPMA, CHC David is a well-known speaker and educator at chiropractic conferences. He is a certified Coder and Auditor and Healthcare Compliance expert. Dr. Jay and Brad talk with their long-time friend who is the Co-founder of PayDC, a web-based patient conversion, reimbursement and compliance software system. Certified professional coder and certified professional auditor through the American Academy of Professional Coders (AAPC), and is also certified in healthcare compliance through the Health Care Compliance Board (HCCB). Expertise in coding and compliance consulting stretches over 24 years in the healthcare arena. Has provided training and education to hundreds of healthcare providers in both one-on-one and group settings. Was the past operations and billing director for a 36 office clinic and is the Founder and President of DK Coding & Compliance, Inc. a health care consulting firm that focuses on audit defense, education, compliance and reimbursement issues.
For many lawyers, going in-house continues to be an attractive career option. But the lawyers I speak to have a lot of questions about making a transition to in-house. They ask me about the timing, how to find good in-house jobs, how practicing in a corporate law department differs from private practice and how in-house jobs differ from each other. In this episode, I speak with David Sclar who has a lot to say on the subject. David is author of Workplace Strategies for Technology Lawyers, and he is joins me from Washington DC where he works as Healthcare Compliance and Privacy Officer for WW (formerly known as Weight Watchers.) David began his career doing a clerkship with the U.S. Bankruptcy Court. He worked at two AmLaw 100 firms and prior to joining WW, he spent 6 years at a healthcare company until the company was acquired. David has a lot of wisdom to share on going in-house Additional Podcasts and Resources What I've Learned as In-House Counsel Frequently Asked Questions About Going In-House Episode 49-Adapting to Change, Pivoting to In-house and DEI in the Legal Profession Episode 39-An In-house Career in the Life Sciences
Compliance is a complex piece when you're a traveling healthcare professional. Kamana is a free platform that can help you better organize and streamline the compliance process. The control is in your hands. Check it out here: kamanahealth.com Scroll to the bottom or their website (kamanahealth.com) and feel free to reach out to Dave or John with any questions.
Protecting patient information is critical. But it is a delicate balance between minimizing a healthcare organization's risk and enabling development staff to raise mission-critical funds. In this episode Marti Arvin, Executive Advisor at CynergisTek, joins Blackbaud's Liza Turcotte for a candid discussion on working together to create this appropriate balance. Topics Discussed in This Episode: Compliance officer's viewpoint on sharing patient data Grateful patient programs Creating a balance between data needed and wanted Expectations for the development team related to patient information Ideas for working together as a team DISCLAIMER: Nothing in this podcast is intended to be legal advice—please consult your organization's own legal counsel. Resources: Marti Arvin White Paper: HIPAA and Fundraising: Understanding the Regulations, Roles, and Compliance Quotes: “The risk appetite of the organization is something that's up to senior leadership.” “As long as I felt my leadership had made an informed decision, I could sleep at night.” “It's not just HIPAA in all cases that you have to consider, so if you've made yourself aware of what the HIPPA regulations are, that may not be enough.”
On this episode of Health+Tech, Andrea Linna, Janice Suchyta and Jonathan Ishee speak with McGuireWoods partner Michael Podberesky about government enforcement trends at the intersection of healthcare and technology. A former federal prosecutor in the U.S. Department of Justice's Civil Fraud Section, Michael recently joined McGuireWoods' nationally recognized Government Investigations & White Collar Litigation and Healthcare Departments and co-chairs the firm's False Claims Act investigations, litigation and enforcement team. On this podcast we discuss: Post-pandemic compliance and enforcement The Biden administration's digital health enforcement priorities Preparing for enforcement in an evolving regulatory landscape Addressing billing errors that occurred during the pandemic Government investigations and prosecutor's enforcement approach among different sizes and types of providers Responding to a subpoena or civil investigative demand
Welcome to the Great Women in Compliance Podcast, co-hosted by Lisa Fine and Mary Shirley. Welcome back to the second episode in a two-part series on Healthcare Compliance, this time with Melanie Sponholz Chief Compliance Officer WCP Healthcare. We discuss Melanie’s unique story starting out in non-Compliance roles and of course eventually finding her Compliance destiny. Along the way, Mel has lived in a large number of cities and feels comfortable with the idea of re-locating, noting the benefits this can have for one’s career and broadening your mind. We talk about data privacy in Healthcare Compliance as well as the characteristics that make someone successful in Healthcare Compliance. This episode will therefore likely be of special interest to anyone looking to transition into Healthcare Compliance. We like to share advice and tips on the podcast via our learned guests but some things don’t have immediate answers, including some aspects of what we’ve canvassed today. If you’d like to share your thoughts on the issues raised, we invite you to connect with us at GWICpod@gmail.com. The Great Women in Compliance Podcast is proudly featured on the Compliance Podcast Network and sponsored by Corporate Compliance Insights. If you enjoyed this episode please subscribe to the podcast and rate it on your podcast player to help other compliance professionals find it. Want to hear more from us? We have a book, “Sending the Elevator Back Down: What We’ve Learned from Great Women in Compliance” (CCI Press, 2020) which is available on Amazon.com and Book Depository. If you’ve already read the booked and liked it, will you help out other women to make the decision to leverage off the tips and advice given by rating the book and giving it a glowing review on Amazon? As always, we are so grateful for all of your support and if you have any feedback or suggestions for our 2021 line up or would just like to reach out and say hello, we always welcome hearing from our listeners. You can subscribe to the Great Women in Compliance podcast on any podcast player by searching for it and we welcome new subscribers to our podcast. Join the Great Women in Compliance community on LinkedIn here.
Welcome to the Great Women in Compliance Podcast, co-hosted by Lisa Fine and Mary Shirley. We’re pleased to introduce our latest two part series on Great Women in Compliance this week – a focus on Healthcare Compliance! In part one we speak with Donna Schneider Lifespan Vice President, Corporate Compliance and Internal Audit. In an unconventional start for GWIC, we begin the episode by level setting on the topic of what Healthcare Compliance is compared with similar industry areas and some of the unique topics that fall under Healthcare Compliance, both in the US and internationally before launching into Donna’s fascinating background as a healthcare provider herself initially, before joining the Compliance realm. Donna shares her subject matter expertise by commenting on pressing issues of the day for Healthcare Chief Compliance Officers. For anyone looking to transition into Healthcare Compliance, you’ll want to tune into this episode as Donna shares her tips for those job hunting and in particular hoping to be a Healthcare Compliance professional. Donna and Mary also ruminate about the benefits of Compliance certifications and volunteering – they could just set you a apart as a shining candidate in a job search. We seek Donna’s advice for Compliance Officers seeking zen and balance after your temper has been tested at work. Tune in for tips from someone who has seen and done a lot in her career and unsurprisingly has some sound tips to take away to keep a sense of calm in even the most stressful of moments. Mary wraps up the episode with the first of a two pronged speak up campaign – the first prong focuses on the deterrent that staff believe that speaking up is futile. Tune in to our second episode in the Healthcare Compliance series to hear from Mel Sponholz and the second step in Mary’s speak up campaign. We like to share advice and tips on the podcast via our learned guests but some things don’t have immediate answers, including some aspects of what we’ve canvassed today. If you’d like to share your thoughts on the issues raised, we invite you to connect with us at GWICpod@gmail.com. The Great Women in Compliance Podcast is proudly featured on the Compliance Podcast Network and sponsored by Corporate Compliance Insights. If you enjoyed this episode please subscribe to the podcast and rate it on your podcast player to help other compliance professionals find it. Want to hear more from us? We have a book, “Sending the Elevator Back Down: What We’ve Learned from Great Women in Compliance” (CCI Press, 2020) which is available on Amazon.com and Book Depository. If you’ve already read the booked and liked it, will you help out other women to make the decision to leverage off the tips and advice given by rating the book and giving it a glowing review on Amazon? As always, we are so grateful for all of your support and if you have any feedback or suggestions for our 2021 line up or would just like to reach out and say hello, we always welcome hearing from our listeners. You can subscribe to the Great Women in Compliance podcast on any podcast player by searching for it and we welcome new subscribers to our podcast. Join the Great Women in Compliance community on LinkedIn here.
Post By: Adam Turteltaub Laws like EMTALA and HIPAA don’t just apply to US citizens. They apply to everyone. That both keeps things simpler and adds complexity when it comes to undocumented immigrations. As Lesley Anne Durant, Senior Corporate Counsel-Regulatory for United Surgical Partners explains in this podcast, if someone without documents appears in the ER, the hospital still needs to provide a medical screening exam, treat and stabilize the patient. But, when it comes to patient privacy, things grow more complex. HIPAA does provide exceptions for law enforcement. However, she notes, hospitals need to consider them carefully. While a disclosure may be permissible, the hospital may not be obligated to disclose the patient information without a court order. And, if patients fear their information may be disclosed, they may not seek treatment. That can be particularly dangerous during this time of pandemic. Other issues that pose compliance risks include: Minors without a parent or guardian present, or in custody Victims of assault, including sexual assault Human trafficking and modern slavery
Compliance is a complex piece when you're a traveling healthcare professional. Kamana is a free platform that can help you better organize and streamline the compliance process. The control is in your hands. Check it out here: kamanahealth.com Scroll to the bottom or their website (kamanahealth.com) and feel free to reach out to Dave or John with any questions.
Planning a med-pharma event requires navigating a complex maze of regulations and laws on the federal and state levels — not to mention new rules in a growing number of international destinations. But keeping your eye only on compliance can dull the engagement elements. Health-care professionals are people, too, and want to meet at memorable venues, hear great speakers and partake in fun activities as much as any other attendee. For this episode of Eventful, sponsored by Visit Seattle, we speak with experts on med-pharma meetings about how to create impactful events for these industries to ensure compliance and produce an engaging gathering. Guests include: Pat Schaumann, president of Schaumann Consulting Group, the former senior director of health-care compliance for both Maritz Global Events and Meeting Professionals International. She is the author of Breaking the Code to Healthcare Compliance. Windy Christner, senior director of meetings and expositions for the American Pharmacists Association, which hosts educational programming throughout the year, including a 6,000-person annual meeting in March and the 1,000-person Joint Federal Pharmacy Seminar. Katie Koziol, director of client services at Ashfield Meetings & Events, which specializes in health-care meetings and has published a series of guides and white papers on planning med-pharma events. This episode is sponsored by Visit Seattle.
This Wednesday's Interview is the 12th installment in the Self-Construction Block of podcasts. This weeks focus is The Effect of Applying the Love Languages to Yourself. Our guest will guide us through the process of understanding love, and applying that energy to our lives. She eloquently expresses her concepts using a great deal of transparency and honesty about some of the trials that she has overcome in her life. This Wednesday's guest is Jessica Hawkins. Jessica Hawkins is a Relationship Coach, workshop facilitator, and aspiring author known for her relationship blog Beyond Unrequited Love. Her blog focuses on re-building, re-pairing, and re-storing broken relationships. Her most recent blogs topics span from self-love to forgiveness. She is a compliance specialist for Bridgeway Rehabilitation Services Inc., in Elizabeth, NJ. At Bridgeway Jessica ensures that the company maintains their accreditation and licensure. She does so by conducting internal audits, in which she was been successful in achieving a 98% compliance goal in her agency. Later this year Jessica is expecting to become certified in Healthcare Compliance. Jessica is an African-American communicator and thought leader. She graduated from the Pennsylvania State University with a Bachelor of Arts in Communications of Arts and Sciences. While at Penn State she served as board member for the student union. She also served as the Student Government Association President for the university. She prides herself on being a loving daughter, sister, and girlfriend. In her free time away from her busy schedule she enjoys traveling, spending time with family, and crocheting. --- Support this podcast: https://anchor.fm/theliberatorspodcast/support
First Healthcare Compliance hosts Jennifer Gimler Brady, Partner and General Counsel at Potter Anderson & Corroon LLP for an interactive discussion on “The Role of Boards in Healthcare Compliance.” Jennifer will discuss the compliance function of boards of healthcare entities during this presentation. Educational Objectives: 1. The presentation will review the primary functions, responsibilities and The post The Role of Boards in Healthcare Compliance appeared first on First Healthcare Compliance.
In this special five-part podcast series, sponsored by Affiliated Monitors, Inc., I visit with AMI Managing Director Jesse Caplan on emerging issues in healthcare compliance and monitoring. In Episode 1, Jesse Caplan discussed the many different types of potential regulatory and liability risks healthcare provider organizations and practices face in connection with the prescribing of opioids. In this Episode, we discuss how healthcare organizations can identify and mitigate the risks from opioid prescribing by their practitioners. Some of the issues considered are: What can healthcare organizations, and particularly their compliance departments do to identify and mitigate the risks from opioid prescribing? Can you give us some examples of deficient opioid prescribing practices by, otherwise, experienced and caring physicians? What help is available to healthcare organizations to address these risks? Do monitoring firms like AMI provide these types of proactive assessments of opioid prescribing programs and practices? Join us for Episode 3, where we discuss the expanding use of independent monitors by health regulators. For more information on Affiliated Monitors, check out their website here. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this special five part podcast series, sponsor by Affiliated Monitors, I visit with Jesse Caplan, Managing Director at AMI on emerging issues in healthcare compliance and monitoring. Healthcare provider organizations and practices face many different types of potential regulatory and liability risks – in this first episode we focus on the risks posed by opioid prescribing. We consider the some of the following issues: >What are the risks to providers and health care organizations from opioid prescribing? >What has been the response of the Department of Justice? >What are legislators and regulators doing to address the opioid crisis? >Can you tell us a little more about the legal and regulatory framework impacting opioid prescribing? >What should be the primary compliance concerns for healthcare organizations in connection with the opioid crisis? Join us for Episode 2, where we discuss how healthcare organizations can identify and mitigate the risks from opioid prescribing. For more information on our sponsor Affiliated Monitors, check out their website here. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this special five-part podcast series, sponsored by Affiliated Monitors, Inc., I visit with AMI Managing Director Jesse Caplan on emerging issues in healthcare compliance and monitoring. In this Episode, Jesse Caplan discusses how health regulatory agencies are using independent monitoring to serve important public policy goals – specifically to help ensure a ready supply of quality healthcare providers, particularly for government programs like Medicaid and Medicare. We consider some of the following issues: In previous episodes, you and your colleagues at affiliated monitors have talked about how independent monitoring can effectively and efficiently extend the ability of government regulators to oversee healthcare providers and organizations. can you explain some more about how independent monitors can serve this purpose? In most cases, a monitor has to be approved by the government regulator or enforcement agency – what’s the value to the government of approving a monitoring relationship? What about the healthcare organization – what are the benefits of an independent monitoring situation? Can you give us some recent examples of where healthcare regulators are using independent monitors in different contexts? Join us for Episode 4, where we discuss independent integrity monitoring of healthcare organizations or systems. For more information on Affiliated Monitors, check out their website here. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this special five-part podcast series, sponsored by Affiliated Monitors, Inc., I visit with AMI Managing Director Jesse Caplan on emerging issues in healthcare compliance and monitoring. In the previous episodes, we considered how healthcare organizations can benefit by having an independent compliance expert – a fresh set of eyes, so to speak – evaluate the organization’s compliance program. We explored the emerging risks involved in opioid prescribing and how organizations can mitigate that risk by pro-actively assessing the prescribing practices of their physicians and physician extenders. In this final episode we discuss how an independent integrity review can be helpful for organizations that may be facing actual or potential compliance issues. We consider some of the following: Can independent integrity review and monitoring be helpful where a healthcare organization may have reason to believe it has an actual or potential compliance problem, but has not yet been subject to an enforcement action or a corporate integrity agreement imposed by the government? How can engaging an independent integrity monitor help an organization in dealing with an enforcement agency? Why do government enforcement and regulatory agencies prefer not to exclude important health care providers who have compliance issues? For more information on Affiliated Monitors, check out their website here. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this special five-part podcast series, sponsored by Affiliated Monitors, Inc., I visit with AMI Managing Director Jesse Caplan on emerging issues in healthcare compliance and monitoring. In the Episode 3, we discussed how independent monitoring can serve important public policy goals in the healthcare industry. In this Episode 4, we consider examples of independent monitoring involving healthcare organizations or systems. How do healthcare organizations or the agencies that regulate them may use monitoring in connection with significant business transactions – as opposed to law enforcement or disciplinary proceedings. What are some examples of where organizations and government regulators have jointly agreed to use an independent firm to monitor implementation and compliance with conditions of a healthcare transactions? Join us for our final installment, Episode 5, where we tie it all together by discussing how to use an independent integrity monitor in a proactive approach that can lead to greater business efficiency and profitability. For more information on Affiliated Monitors, check out their website here. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this session, learn how to architect for AWS for healthcare compliance. Join Pat Combes, AWS Healthcare Technical Lead, and hear the latest on AWS HIPAA-Eligible Services, European General Data Protection Regulation (GDPR), and ISO 13485. Learn about some general patterns and common architectures that you can use to decouple protected data from processing and orchestration. Understand how to track where data flows though automation, and learn how to have logical boundaries between protected and general workflows
“As we’re looking into alternative revenue streams and new methods of delivering care, what happens is the innovation kind of takes over. The things that we have regulatory requirements around, such as Stark and then kickbacks, are things where the government or the required regulatory rules haven’t quite caught up with where healthcare needs to go for the future. You’re looking at these different contractible arrangements and working in these different capacities with partners and trying to decide, okay, from a regulatory perspective, how might this affect us?” This is one of the many observations from Sheryl Vacca, Senior Vice President and Chief Risk Officer at Providence St. Joseph Health, a $22 billion organization with 103,000 caregivers across seven states. With over thirty years of healthcare, compliance, and auditing experience, Sheryl's responsibilities include oversight for compliance, audit, risk management, and information security. In this episode of Second Opinions, Vacca talks about how healthcare compliance and compliance staff are changing across the healthcare continuum as the industry continues to focus on new methods of care delivery and embrace preventive care.
Sharon interviews Dr. Eddie Hu, President of American College of Physician Advisors
Sharon interviews Valerie Watzlaf,2018 AHIMA President
Compliance Mastermind: Strategies for your healthcare compliance program and your career
On today's show I am talking about what is next for the podcast in 2018 and highlight 12 podcasts you will want to check out while this one is taking some time off for the Holidays. I can't wait to share new episodes, new compliance leaders, and some great content with you in the new year. In no particular order, here are links to the podcasts I mention on the show. If the show has a website I link directly to that, if not I will give the link to the show in iTunes. 1. Compliance Conversations: https://www.healthicity.com/blog/topic/compliance-conversations 2. Compliance Perspectives: http://complianceandethics.org/category/podcasts/ 3. Help me with HIPAA: https://helpmewithhipaa.com/podcasts/ 4. Compliance Beat: http://www.compliancebeat.com/episodes/ 5. 1st Healthcare Compliance: https://1sthcc.com/category/podcasts/ 6. Masters of Disaster: http://www.complyethic.com/podcast/ 7. FCPA Compliance and Ethics Report: http://fcpacompliancereport.com/podcasts/ 8. Get Social Health: http://getsocialhealth.com 9. 10 Minute Check Up: https://itunes.apple.com/us/podcast/10-minute-check-up/id1293939877?mt=2 10. Pharmacy Podcast Network: http://pharmacypodcast.com/podcasts/ 11. The Future of Healthcare: https://itunes.apple.com/us/podcast/the-future-of-healthcare/id1266164957?mt=2 12. Red Hot Healthcare: https://redhothealthcare.com/the-podcast/ Remember to subscribe to the show! Disclaimer: On this podcast I speak only for myself and what I share are the opinions of me alone. My guests also speak for themselves only and do not represent the opinions of their firms or organizations. All content provided on this podcast is for information purposes only. Neither I or my guests make any representations as to the accuracy or completeness of any information on the podcast or in the show notes. This podcast should not be used in any legal capacity whatsoever. Please consult a qualified attorney before taking any action that could have legal implications to you or your business.
Steve Rutkovitz, President and CEO of ChoiceTech joins First Healthcare Compliance to discuss the importance of a risk assessment for a medical practice. The post Why a Risk Assessment Is So Important For Your Practice appeared first on First Healthcare Compliance.
Steve Rutkovitz, President and CEO of ChoiceTech joins First Healthcare Compliance to discuss the importance of a risk assessment for a medical practice. The post Why a Risk Assessment Is So Important For Your Practice appeared first on First Healthcare Compliance.
A 1 minute excerpt from a recent interview. Hear the full interview by entering the Guest's name into our search index at www.ExitCoachRadio.com. We upload new content daily so check back often! Transcript: Minda: There's a lot of reporting, actually, that you're required to do. I have a checklist that people can email me and request, that says, you know, what documents you have to send in and when they're required. You have to give notices to your employees about their healthcare options, when you employ them you have to give them annual notices, you have to provide certain information to the IRS about your employees, you have to have certain systems in place for monitoring health care, you have to report healthcare dollars that you spend for them on their W-2s, and there's a whole litany of things you have to do. Listeners: You asked, so we found FREE solutions for 5 of your top problem areas. Text “TOOLBELT” to 44222 or click here
Talking Compliance On this week’s episode with Medical Association of Georgia, healthcare law expert, Liz Schoen stopped by to share information regarding compliance with current healthcare law and regulations on Top Docs Radio. Liz Schoen has more than 25 years of experience in the health care field. She serves as a legal and business advisor […] The post Talking Compliance – Top Docs Radio appeared first on Business RadioX ®.
Fletch talks to IR's Kevin Donovan about the role of Prognosis providing solutions for the big challenges for today’s healthcare IT organizations and assist them addressing issues such as compliance reporting. Fletch is joined by Denise Gilardone a business development manager with Avaya's DevConnect program to discuss the value and benefit delivered to the customer from applicaiton testing.
Fletch talks to IR's Kevin Donovan about the role of Prognosis providing solutions for the big challenges for today’s healthcare IT organizations and assist them addressing issues such as compliance reporting. Fletch is joined by Denise Gilardone a business development manager with Avaya's DevConnect program to discuss the value and benefit delivered to the customer from applicaiton testing.