News+PR
The latest from industry trends and happening in the compliance.
Navigating Healthcare Compliance in Private Equity: Essential Amidst Slow Deal Flow and Rising Interest Rates
In the ever-evolving landscape of Healthcare Services private equity, the importance of compliance within portfolio companies cannot be overstated. As deal flow experiences a slowdown and interest rates remain on the high side, private equity firms find themselves in...
Client Highlight: Sunny Days Sunshine Center
We recently sat down with K. David Holmes, Consulting Chief Program Officer and Compliance Office for Sunny Days Sunshine Center, a large and prominent development center for children with autism spectrum disorder and other developmental delays, to talk about the...
Ensuring ADA Compliance and Accessibility for All Patients in Your Practice
In today's healthcare landscape, ensuring compliance with the Americans with Disabilities Act (ADA) is crucial to providing inclusive and accessible services for all patients. Individuals with disabilities continue to lack equal access to routine preventative medical...
Navigating Increased Audits in the Behavioral Health Industry Post-COVID
In the wake of the COVID-19 pandemic, the behavioral health industry finds itself under an intensified magnifying glass, with notable increased interest and activity from the Private Equity community and consolidation in the behavioral health space, it’s no...
Increasing Government Oversight Continues for Risk Adjustment (HCC) Coding Compliance
Risk Adjustment (HCC) coding compliance is quickly becoming the forefront of primary care across the nation as value-based care models continue to be implemented within the healthcare industry. With the added administrative burden placed upon providers and...
Will 2023 Finally Usher in the New HIPAA Regulations
Back on December 10, 2020, the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) issued the Notice of Proposed Rulemaking (NPRM) with proposed changes to the Privacy Rule. The proposed modifications support individuals’ engagement in their...
Misconceptions About the Cost of Healthcare Compliance
I have been actively engaged in healthcare compliance for the last 25 years. Over that time, I have frequently heard the complaint that compliance is a costly nuisance. Why is it so expensive? Is there a way around it? Who pays for this unfunded mandate? I’ll let you...
Three Options for Medical Practices in Today’s Disruptive Financial Climate
The healthcare industry, and physician practices in particular, are experienced at weathering industry disruptors and a landscape that seems to be in perpetual change. However, the last few years have seen a notable increase in mergers and acquisitions, with all...
Cybersecurity: Does Your IT/Managed Service Provider Have Your Best Interest?
It has been a little over a year since the passage of the Cyber Incident Reporting for Critical Infrastructure Act (CIRCIA). Enactment of CIRCIA marks an important milestone in improving America’s cybersecurity by, among other things, requiring the Cybersecurity and...
The Importance of Full Threat Assessments
After surveying thousands of physician practices over the last thirty years, we are still surprised at how many calls we receive about what a Full Threat Assessment looks like. This is especially true of the ones that are required by insurance companies, as well as by...
Healthcare Highlights from the Presidential Proposed FY24 Budget
President Biden released his proposed FY2024 budget at the beginning of March. Though the budget must still clear the hurdle of Congressional approval, its final version is likely to have significant impact on health care organizations. The proposed changes cast a...
Podcast: The Dos and Don’ts of Medical Payer Audits: How to Identify and Respond to Them
The Dos and Don’ts of Medical Payer Audits: How to Identify and Respond to Them
ABSTRACT Prior to the COVID-19 pandemic, medical providers were routinely audited by public and private payers. Since the pandemic, when many payers were forced to pay for expensive COVID-19 related testing and treatment, payer audits have increased. When a provider...
Back to Basics
The last two and a half years have been anything but business as usual for physician practices and healthcare organizations. From scrambling for PPE in the initial stages of the pandemic, to refitting offices and implementing processes to keep patients and staff safe,...
Lessons for Physician Practices from their Security Risk Assessment
Far too often, physician practices leave the heavy lifting of their Security Risk Assessment (SRA) to their IT team, IT vendor, or Managed Service Provider (MSP). It is true that much of the SRA focuses on technical safeguards, but it is critical that elements of the...
Healthcare Disruptors
Consolidation in healthcare is causing a lot of disruption and increasing Private Equity investment in the healthcare services space. Industry experts highlighted several disruptors facing the industry and shared insights to the future landscape that are key,...
2023 CPT Coding Changes
The following is a synopsis of the major changes to CPT that will take effect January 1, 2023.
2022 MIPS Risks – Are You Ready?
For the last few years, MIPS (Merit-Based Incentive Payment System) has been avoidable primarily due to COVID-19 and other hardships. However, 2022 seems to be the year when there is going to be pushback on the practices making it more difficult to get an exemption....