Fraud, Waste, and Abuse (FWA) can have serious implications for the healthcare industry, affecting patient care, financial stability, and organizational integrity. Detecting and responding to FWA offenses promptly and appropriately is essential to protect the well-being of patients, uphold ethical standards, and maintain regulatory compliance. Effective strategies and best practices are imperative for responding to detected FWA offenses in healthcare, ensuring swift action and minimizing potential risks for your organization. 1. Understand the gravity of the situation: When a potential FWA of ..read more

  Employee hotlines are an invaluable tool for healthcare organizations aiming to create a culture of compliance, transparency, and accountability. In our latest blog, we will address some of the most common questions about employee hotlines in healthcare, shedding light on their importance, benefits, and best practices for implementation. 1: Why are employee hotlines crucial in healthcare organizations? Employee hotlines are crucial because they provide a confidential and secure channel for employees to report concerns, misconduct, and potential compliance violations. They empower emplo ..read more

In the ever-evolving landscape of healthcare regulations, one crucial aspect that healthcare entities must prioritize is exclusion screening. Exclusion screening refers to the process of checking individuals and entities against various exclusion lists to ensure compliance with federal and state regulations. Failing to comply with exclusion screening requirements can have serious consequences for your organization. In this blog post, we will explore the importance of exclusion screening, its benefits, and how partnering with the right experts can help you navigate this critical aspect of heal ..read more

1st Talk Compliance features attorneys Sean McKenna, Lauren Nelson, and Vincent Aiello of Spencer Fane LLP, on the topic of Healthcare Assets: How to Preserve and Protect. Sean, Lauren, and Vince join our host Catherine Short to discuss the interplay between enforcement and liability proceedings with asset protection, explore how government and private litigation matters can impact healthcare companies, clinicians, and executives, and provide tips and preventative strategies to preserve income and assets prior to such action to ensure business continuity and succession planning. &nb ..read more

Expert presenter, Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX guides us through current trends and tips. With its roots stemming back to 1863, the False Claims Act continues to be the U.S. Department of Justice’s primary enforcement tool for returning money to the Federal Treasury. It is also considered one of five fundamental fraud, waste, and abuse laws, which potentially impact a provider every time a claim is submitted to Medicare, Medicaid, and other government programs because of the attestation language. The purpose of this webinar is ..read more

1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of A Practical Approach to The Safe Harbor Law. Ray joins our host Catherine Short to discuss how HIPAA data breach penalties typically get measured in millions of dollars, even following an organization implementing NIST cybersecurity framework measures. However, with the new HIPAA Safe Harbor Law, signed in January 2021, HHS and OCR may consider some penalty mitigation. It is important to understand that the Safe Harbor Law, while offering substantial protection, does not provide a true safe ..read more

Raymond Ribble is the CEO and Founder at SPHER, Inc. a market-leading compliance analytics, cyber-security solution addressing: HIPAA compliance, State Privacy Laws, and ePHI security threats and our expert presenter for this webinar. HIPAA data breach penalties typically get measured in millions of dollars even following an organization implementing NIST cybersecurity framework measures. With the new HIPAA Safe Harbor Law, signed last January of 2021, HHS and OCR may consider increased penalty mitigation when an organization can demonstrate it has been following established good security prac ..read more

Shauna Itri, Partner at Seeger Weiss LLP recently presented the webinar “Fraud, Healthcare, COVID-19, and the False Claims Act.” Shauna returned to answer many commonly asked questions from the webinar. Can someone be retaliated against for filing a False Claims Act case? Are there any protections?  Absolutely, and yes.  Thankfully there are incentives and protections involved in filing a qui tam case. The incentive comes in the form of a monetary award. If a qui tam case is successful, the whistleblower will get a portion of the recovery. The percentage depends on several factors a ..read more

Sonal Patel, CPMA, CPC, CMC, ICD-10-CM, Healthcare Coder and Compliance Consultant at Nexsen Pruet, LLC, presented the webinar “Have No Fear: Auditing to Benefit Healthcare Entities, A Step Towards Proactive Compliance” recently and a recording can be viewed here. Sonal returned to answer many commonly asked questions from the webinar. Why do you think physicians and practices are not conducting self-audits? Great question! There’s likely a multi-faceted answer for that. But, in my opinion, I think there is not enough attention on the data. I truly believe the data speaks volumes and the data ..read more

1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., on the topic of DMEPOS – In Compliance with CMS. Rachel joins our host Catherine Short to discuss special payment rules associated with durable medical equipment, prosthetics, orthotics and supplies. DMEPOS products must meet quality standards, suppliers need to be accepted by Medicare to participate, similar to providers, and are subject to fraud, waste, and abuse laws. This episode will provide an overview of participation and quality requirements, relay the ..read more