An encore presentation from Episode 33 In a recent episode of our podcast, we stepped away from our usual audience of compliance professionals to deliver an important message directly to CEOs and executive leadership. If...more
In the latest episode of The Healthcare Compliance Pod, we unpack how to provide meaningful access to language assistance – a topic that’s not only legally relevant due to Section 1557 changes but vital to patient safety and...more
If you’re preparing to launch an audit within your healthcare organization, pause for a moment and consider this: how well you plan before the audit begins can significantly affect the outcome—and your risk exposure. This...more
If you’re trying to strengthen your organization’s compliance program, one of the most important recommendations from the Office of Inspector General’s (OIG) General Compliance Program Guidance is to integrate quality and...more
As we hit the halfway point of 2025, now is the perfect time to revisit your compliance work plan. While it’s always good practice to assess whether your organization is meeting its compliance goals, this year presents a...more
6/20/2025
/ Compliance ,
Department of Justice (DOJ) ,
Diversity and Inclusion Standards (D&I) ,
Enforcement Priorities ,
False Claims Act (FCA) ,
Federal Funding ,
Gender Identity ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Risk Management
Physician compensation benchmarks like those from the Medical Group Management Association (MGMA) or the American Medical Group Associations) AMGA are commonly used in the healthcare industry. Organizations lean on them for...more
In today’s complex healthcare landscape, whistleblower claims are a major source of regulatory and legal risk for organizations. Last year saw a record number of “qui tam” claims filed under the False Claims Act. While...more
In April, a pharmaceutical manufacturer agreed to pay a $202 million settlement to resolve allegations of Anti-Kickback Statute (AKS) violations. At the heart of the case were speaker programs, where physicians and...more
The compliance officer is one of the most important positions within a healthcare organization, but also one of the most challenging. You’re expected to be a teacher, a coach, a project manager, a good listener, and a role...more
5/22/2025
/ Audits ,
Chief Compliance Officers ,
Compliance ,
Corporate Governance ,
Employees ,
Ethics ,
Health Care Providers ,
Healthcare ,
Healthcare Workers ,
Policies and Procedures ,
Risk Management ,
Training
In a recent False Claims Act case, a long-term care pharmacy and consulting services provider was found liable for submitting false claims to the government, resulting in a jury verdict of over $135 million in damages. The...more
If your organization uses Electronic Health Records (EHRs), the recent updates to the SAFER Guidelines (Safety Assurance Factors for EHR Resilience) are essential for helping you assess the potential safety issues posed by...more
5/8/2025
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
EHR ,
Electronic Medical Records ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
Risk Assessment ,
Risk Management
Effective May 1, 2025, the Section 1557 regulations require covered healthcare providers to take reasonable steps by May 1, 2025, to identify and mitigate the risk of discrimination when they use AI and other emergency...more
4/24/2025
/ Algorithms ,
Artificial Intelligence ,
Bias ,
Compliance ,
Discrimination ,
Health Care Providers ,
Health Technology ,
Healthcare ,
Regulatory Requirements ,
Risk Management ,
Section 1557
Drug diversion can pose serious risks to patients, employees, and organizations. Any provider who stores, transports, or dispenses controlled substances should have a robust program designed to deter drug diversion and to...more
Delegated credentialing for telehealth providers has become commonplace since the Centers for Medicare & Medicaid Services (CMS) relaxed the Medicare Conditions of Participation for hospitals more than 10 years ago. Delegated...more
Compliance training is one of the most important responsibilities of the compliance officer. A provider’s best defense to non-compliance is well-trained employees who understand and follow your policies....more
Many healthcare organizations understand the importance of having a Compliance Committee but some struggle to use their committee effectively. The key to ensuring the Compliance Committee is effective is building smart...more
3/3/2025
/ Compliance ,
Compliance Monitoring ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
OIG ,
Policies and Procedures ,
Regulatory Requirements ,
Risk Assessment ,
Risk Management
It is not uncommon for healthcare providers to want to offer employees a discount on their services as a way to show their appreciation and as an added benefit to retain and attract candidates. While these discount programs...more
“Almost every stage of modern healthcare relies on stable and secure computer and network technologies.”
The above is a direct quote from the Office of Civil Rights for Health & Human Services (“OCR”) in its proposed...more
1/31/2025
/ Cybersecurity ,
Data Breach ,
Data Privacy ,
Data Security ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Technology ,
Healthcare ,
HIPAA Security Rule ,
OCR ,
Patient Privacy Rights ,
Risk Management
As we routinely discuss on the podcast, much of the success of an organization’s compliance program depends on its culture. Creating and fostering a compliance-minded culture can help ensure employees report suspected...more
As we start a new year, January is a great time to plan ways to refresh your compliance programming for the upcoming year. Compliance training and activities can become stale. They often take a backseat to the day-to-day...more
In healthcare, compliance issues can quickly escalate into compliance nightmares, with serious implications for patient safety, legal liability, and an organization’s reputation. Among the most common compliance nightmares...more
Undoubtedly one of the most important responsibilities of the compliance officer is compliance training. Your best defense to a compliance problem is well-trained staff who not only know the organization’s policies but also...more
The most successful compliance programs are constantly evolving and always in motion. They are both action-oriented and flexible. How do you build a program that’s action-oriented and flexible? You implement a detailed work...more
Most healthcare providers understand the importance of having a designated Compliance Officer. Someone needs to lead the organization’s compliance initiatives and be responsible for advising the CEO and governing body of...more
Sometimes we forget that even small and medium-sized providers can run afoul of antitrust laws and regulations. Often these activities are well-intentioned. It’s not uncommon for competing providers to want to work together...more