Blog Posts by Tag: Compliance
No Surprises Act: 2023 Changes and Clarifications
Effective January 1, 2022, the No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing for services received from out-of-network providers.Since January 2022, CMS has published over 50 resources related to the Act, five of which were released as recently as December. In August 2022, CMS issued the final rules, entitled “Requirements Related to...
An Overview of Cybersecurity at XiFin
Marty BarrackChief Legal and Compliance Officer, XiFin, Inc. Michael ConlonAVP Cyber Security, XiFin, Inc. XiFin’s commitment to cybersecurity starts with its focus on appropriate frameworks to guide its cybersecurity efforts. We utilize the National Institute of Standards...
Outsourcing All or Some of the RCM Process Supports Compliance
The healthcare industry is notorious for nearly constant changes in laws, regulations, government, and payor requirements. It is difficult for an individual diagnostic provider to keep up with all the changes, particularly as it relates to compliance. Any compliance misstep can result in lost revenue, fines, and even extreme penalties like debarment, corporate integrity agreements, and criminal...
Must-Have Compliance Capabilities to Manage Risk and Help Drive Growth
Thorough RCM processes address a myriad of compliance issues that can cost an organization money, business freedom, and even exit opportunities. Compliance requirements are continually changing, and any misstep could result in lost revenue, fines, and even extreme penalties such as debarment, corporate integrity agreements, and criminal consequences for the company and responsible individuals. ...
Leverage the Criteria Black Book Research Uses to Select the Best Outsourced RCM Services Provider for Your Organization
This blog is part of a series. Read Part 2 and Part 3. Although diagnostic organizations continue to improve in their ability to make decisions regarding outsourcing revenue cycle management (RCM), many may still benefit from guidance on the most impactful decision criteria. Black Book Research conducts an annual study to understand how diagnostic leaders perceive service providers across 18...
Addressing EKRA Sales Force Compensation Mandates to Improve Both Compliance and Profitability
EKRA - Eliminating Kickbacks in Recovery Act - is a relatively new law that has some important implications for all diagnostic laboratories, and not just toxicology labs, which precipitated the legislation. Passed in October 2018, it was widely understood the law was intended to combat the opioid crisis. Recently, due in part to COVID-19 and government concerns over fraud and abuse, there has...
Seven Factors to an Effective Compliance Program
This is the second article of a multi-part series on the many dimensions of compliance related to diagnostic providers, independent device testing facilities (IDTFs), and hospital outreach laboratory services. The responsibility of compliance does not rest on the shoulders of one individual or committee. Compliance responsibility for laboratories, IDTFs, pathology practices, and hospital outreach...
Building an Effective Compliance Program and Compliant Diagnostic Systems That Work: An Overview
This blog was updated on July 8, 2022. The healthcare industry is in a state of constant change in laws, regulations, reimbursement and payor requirements, and commercial and patient expectations. It is hard for any individual healthcare provider to keep up with all of these changes. The diagnostic business, in particular, is under pressure to stay in compliance. Over the course of the next...
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