Compliance Risk Assessment

Home Health Compliance Risks are a Significant Issue for Texas and Oklahoma Agencies

Home Health & Hospice /

(March 21, 2012): Over the past few weeks, several important events have occurred which should have home health agencies in Texas, Oklahoma and the rest of the country rethinking the adequacy of their existing compliance efforts. The home health compliance practices of many agencies have long been a concern of the Department of Health and […]

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Data Mining Tools Can Help Identify Possible Problems

Regulatory Issues | Privacy | Other /

(February 8, 2012): While we all know that many Medicare post-payment audits are often generated as a result of sophisticated data mining analyses, the particular elements of concern which may give rise to a specific provider audit are not always so clear. Health care providers interested in compliance can use data mining assessment tools to

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CMS’s New Physician Compare Website to Report on Provider Performance

Medicare, Medicaid & Private Payor Updates /

(November 15, 2011): Last year, the Centers for Medicare and Medicaid Services (CMS) launched their Physician Compare website. CMS’s Physician Compare website allows beneficiaries to research their health care providers. The Affordable Care Act (commonly referred to as “Health Care Reform”) mandated that CMS launch such a website and that it implement physician performance metrics

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Conducting a Gap Analysis / Mock Audit: An Essential Compliance Tool for Your Practice

Medicare, Medicaid & Private Payor Updates /

(November 15, 2011): Understandably, health care providers have grown weary of government audits, malpractice issues, peer reviews and private payor assessments. In an effort to reduce their potential liability, many providers are now regularly utilizing Gap Analyses / Mock Audits to test their preparedness for audit. In doing so, they have been able to identify

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Ten Recommendations to Improve Medicare Compliance and Prepare for a ZPIC Audit

Medicare, Medicaid & Private Payor Updates /

(July 24, 2011): Has your Texas physician practice, home health agency, hospice, DME company or PT / OT / ST clinic been audited by a Zone Program Integrity Program (ZPIC)? If not, it may only be a matter of time. Despite your best efforts to follow Medicare’s directives, your organization may still be identified as

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