Part 2: When Criminal Behavior Infiltrates Your Audit Program   Written by Carl J Byron, CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret)   We Recommend Reading Part 1 Fraud Indicators and Red Flags – When Audit Managers Knowingly Skew Audit Results as this article is Part 2, “the rest of the story.”Subsequent to […] The post Fraud Indicators and Red Flags, Part 2 appeared first on American Institute of Healthcare Compliance ..read more

Part 1:  When Audit Managers Knowingly Skew Audit ResultsWritten by Carl J Byron, CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret) Fraud cannot be eliminated. No system is completely fraud-proof, as any system can be bypassed or manipulated. However, it can be detected early by paying greater attention to common […] The post Fraud Indicators and Red Flags appeared first on American Institute of Healthcare Compliance ..read more

Written by: Shelby Harriel-Hidlebaugh,  M.Ed. and BA  The medical setting is expected to be a sanctuary of dignity and autonomy. However, sensitive exams and other intimate tasks conducted without consent can leave patients feeling violated. Informed consent is a cornerstone of ethical medical practice. It establishes a foundation of trust between patients and healthcare providers and […] The post The Legal and Ethical Imperative of Explicit Consent in Intimate Medical Procedures appeared first on American Institute of Healthcare Compliance ..read more

Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS   This article emphasizes the need of healthcare institutions to focus on building a culture of safety through Root Cause Analysis (RCA) to Manage Clinical Risk is an important management tool.  Read Part 1: Building a Culture of Patient Safety Starts […] The post Culture of Safety is based on Prevention, not Punishment appeared first on American Institute of Healthcare Compliance ..read more

Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS   This article emphasizes the need of healthcare institutions to focus on building a culture of safety through improving care of the workforce.  Read Part 1: Building a Culture of Patient Safety Starts with Reducing Staff Burnout posted December 3, 2024. […] The post An Approach to Reduce Patient and Workforce Harm appeared first on American Institute of Healthcare Compliance ..read more

Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS Patient safety directly relates to reducing mistakes. Increased job-related stress contributes to workforce burnout, a major contributing factor to unsafe practices. Unfortunately, our healthcare workforce faces unprecedented challenges: incidence of violence in the workplace, accelerated rates of burnout, and exposure […] The post Building a Culture of Patient Safety Starts with Reducing Staff Burnout appeared first on American Institute of Healthcare Compliance ..read more

Written by Corliss Collins, BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC and Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS    The 2024 Final Rule for Section 1557 of the Affordable Care Act (ACA) was issued by the Department of Health and Human Services (HHS) on April 26, 2024. The effective date […] The post The Impact of Section 1557 Final Rule on Healthcare appeared first on American Institute of Healthcare Compliance ..read more

Written by Gabriella Neff, RHIA, CHA, CHC, CHRC, CHPC It is all about respect. Transgender individuals are protected under HIPAA, the Affordable Care Act (ACA) and standards outlined for hospital accreditation under Medicare and Medicaid as well as Joint Commission. Hospitals may not have specific requirements for training staff on LGBTQ+ cultural competency and non-discrimination policies […] The post Compliance Considerations when Treating Gender Identity and Gender Diverse Patients appeared first on American Institute of Healthcare Compliance ..read more

Written by Gabriella Neff, RHIA, CHA, CHC, CHRC, CHPC This past year, in 2024, revisions were made to clarify hospital guidelines related to informed consent specifically addressing UIEs (unconsented intimate exams) to patients while under anesthesia.  This article addresses how these privacy rights extend beyond rules designated under HIPAA and States passing rules banning unauthorized pelvic […] The post Comply with Privacy Rights to Avoid Unconsented Intimate Exams appeared first on American Institute of Healthcare Compliance ..read more

Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS Because healthcare organizations are heavily regulated and periodically audited or investigated, conducting internal audits is important to mitigate risk. Internal audits can be an integral part of your corporate compliance program and used as an effective management system, whether it is […] The post Fundamentals of a Healthcare Internal Business System Audit appeared first on American Institute of Healthcare Compliance ..read more