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View All ProductsWe understand the critical importance of earning and maintaining your patients' trust in the delivery of exceptional sedation and surgical outcomes. As a premier provider of healthcare education, we are committed to empowering you in promoting safer, more successful outcomes for each and every patient, without exception.
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Learn MoreCompliance continues to be an area of extreme focus for the healthcare industry, including the care continuum. Where healthcare compliance professionals spend their time is changing as accrediting bodies and regulators find new areas that merit investigation. Healthcare’s low operating margins and tenuous financial health make it easy to say that compliance leaders need to split their attention between traditional activities and the where the future is headed.
In our efforts to identify new compliance directions, content experts from HCCS, A HealthStream Company, recently attended the Health Care Compliance Association’s 2018 Enforcement Conference. We’ve already blogged here about the first round of things they learned. Here is an excerpt from Round 2:
Session Title: Handling a Criminal Health Care Fraud Case
This session was important for compliance professionals, not only because of the DOJ focus areas discussed, but because of the emphasis placed upon how they can prevent healthcare fraud cases. Why is this important? In 2017, the DOJ opened 967 new healthcare fraud investigations—439 of them were cases filed involving 720 defendants, of which 639 were convicted. The focus on healthcare fraud has never been keener. The DOJ continues its work with the opioid crisis, prescription drug fraud, and home health, as well as taking down corrupt medical professionals.
The first line of defense in preventing a criminal case is the compliance program. The use of standard compliance best practices, which includes the seven elements of an effective compliance program, is a good start. The speakers recommended an annual program evaluation using the DOJ’s guidance, “The Evaluation of Corporate Compliance Programs.” There should be:
Compliance Training and Communication
The guidance includes a section on compliance training and communication, which provides probing questions to assist in the evaluation of the program. In part, they are:
Compliance officers must also understand that they, too, may have exposure to liability should there be misconduct in their organization. Taking a proactive stance to detect and prevent it can lessen potential damages. In addition to criminal health care fraud, state privacy enforcement actions were an important topic of discussion.
Download the article that summarizes learning from this HCCA Conference.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
View All ProductsStandardize policy and procedure management with an automated, customized, and centralized system.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementStreamline the revenue cycle management process and protect your bottom line with expert-backed education.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsUnlocking the full potential of clinicians goes beyond aspiration – it’s a commitment we embody. Our competency development solutions help personalize learning for every clinician so you can confidently bridge the gap between theory and practice for your nurse residents while meeting the unique development needs of your seasoned clinician.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing challenges, standardize orientation and onboarding, and deliver an effective training program for your team to easily achieve and maintain certification with our critical, emergency, and acute care solutions.
View All ProductsWe understand the critical importance of earning and maintaining your patients' trust in the delivery of exceptional sedation and surgical outcomes. As a premier provider of healthcare education, we are committed to empowering you in promoting safer, more successful outcomes for each and every patient, without exception.
View All ProductsOur solutions are meticulously designed to cater to the diverse needs of patients, healthcare professionals, and organizations. Within this innovative framework, we have curated specialized subsets of solutions aimed at addressing the ever-evolving challenges faced by individuals dealing with illnesses or chronic conditions.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare workforce management is essential. We provide advanced scheduling solutions for organizations to solve issues such as nurse retention
View All ProductsComprehensive, industry-leading provider onboarding and credentialing software that validate health outcomes and support provider assessment.
View All CredentialingOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
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