Stay informed with the latest healthcare compliance news, regulatory updates, and best practices from our expert team.
Credentialing verifies qualifications to practice; exclusion screening checks whether someone is barred from federal healthcare programs. They are related but not the same - treating them as one process creates audit and False Claims Act risk.
Preparing for a HIPAA OCR audit starts with organized, current documentation that proves compliance with the Privacy, Security, and Breach Notification Rules. This article explains what OCR typically requests, which regulations apply, and how to stay audit-ready year-round.
Yes—most healthcare organizations should perform and document a HIPAA Security Rule risk analysis at least annually, and sooner when systems, vendors, or threats change. HIPAA requires an accurate, thorough, and ongoing assessment of risks to ePHI, not a one-time checklist.
HIPAA does not automatically protect all online health data. Whether fitness trackers, fertility apps, prescription discount platforms, or online therapy tools are covered depends on who operates the service and whether it is acting as a HIPAA covered entity or business associate.
Current healthcare Fraud, Waste, and Abuse enforcement is centered on False Claims Act billing cases, Stark Law and Anti-Kickback financial relationships, and HIPAA security failures. DOJ, OIG, and OCR trends show that unsupported claims, referral-based compensation, and weak risk analysis remain the biggest drivers of settlements and fines.
AI governance is the framework healthcare organizations use to control how AI tools are approved, used, monitored, and retired. If AI touches patient data, billing, documentation, or care decisions, your healthcare company likely needs formal AI governance to manage HIPAA, billing, safety, and bias risks.
Yes—cash-pay and non-Medicare healthcare businesses usually still need a compliance program. Even without Medicare billing, organizations may face HIPAA, state law, commercial payer, documentation, privacy, and licensing risks that require structured oversight.
Does a small medical practice really need a compliance officer? Why? What are the benefits? How can you do this if you don't have a budget for compliance officer?
Healthcare policies should be reviewed at least once a year, and updated immediately whenever regulations, operations, or an incident demand it. Here's how to build a review schedule that keeps your organization audit-ready year-round.
Provide answer to question with references. What is the difference between OIG exclusion Checks, SAM exclusion Checks and State Medicaid Exclusion Checks.
A practical, audit-ready checklist for the HIPAA Security Rule Technical Safeguards — covering Access Control, Audit Controls, Integrity, Authentication, Transmission Security, and Vulnerability Management. Includes the evidence OCR and your insurer most often ask for.
A complete checklist of OIG-aligned requirements every healthcare company should have in place — covering HIPAA policies, data privacy and security, training, auditing, exclusion checks, business associate agreements, and more.
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AI Standards in 2026 - Compliance and Governance
Stay informed with the latest healthcare compliance news, regulatory updates, and best practices from our expert team.
