Compliance
Hospitals, health systems, and physician groups are challenged to keep up with the complicated and ever-changing healthcare regulatory environment. Every week new qui tam lawsuits are unsealed, the Department of Justice announces recent False Claims Act/Stark law/Anti-kickback settlements, new governmental guideline are issued, and more. Further, the federal government and its enforcement agencies show no signs of scaling back their initiatives. In fact, over the past several years, leaders of organizations have been held personally accountable for not only their involvement in wrongdoing but allowing noncompliance to occur on their watch. However, one thing is clear–the existence of a compliance-driven “tone at the top” and an effective corporate compliance program that addresses the seven fundamental elements outlined in the Federal Sentencing Guidelines and made mandatory for healthcare organizations through the Affordable Care Act is both necessary and expected. We are prepared to work with you in various areas of expertise to help your organization respond to these compliance challenges.
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Clinical Information Systems (Selection, Implementation, and Optimization)
As your existing technology system ages or your business needs change, your technology may no longer provide the capabilities required to support your objectives. Our knowledgeable healthcare technology professionals can help you select, implement, and optimize new or current clinical information systems to support your business strategy and help you achieve your goals.
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Compliance Program Effectiveness Assessments
Healthcare organizations are constantly facing new compliance risks and are challenged to keep up with the complicated and ever-changing healthcare regulatory environment. Today, now more than ever, it is vitally important that healthcare organizations maintain an effective compliance program.
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Compliance Risk Assessment Services
Healthcare organizations are constantly facing new compliance risks and are challenged to keep up with the complicated and ever-changing healthcare regulatory environment. Today, now more than ever, it is vitally important that healthcare organizations maintain an effective compliance program.
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Cybersecurity in Healthcare
Cybercrime, while impacting other industries over the past 20 years, has now attacked healthcare in a big way. Daily, we read about security breaches in small-, medium-, and large-scale healthcare organizations that often affect hundreds, thousands, or even millions of people and their private information.
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Fair Market Value and Commercial Reasonableness
Physician and advanced practice provider compensation arrangements are continually progressing in healthcare, as compensation must be competitive with the market and in compliance with the established regulations in the industry. Compensation arrangements are not immune to the emerging developments in healthcare and must meet the standards for fair market value (FMV) and commercial reasonableness (CR).
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Governance Structure Optimization
Many health systems that have spent years building a critical mass of providers now find themselves in a reactive position to physician’s needs. The result may be that the physicians are not adequately integrated into the organization, lacking a unified voice.
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Healthcare Coding and Compliance Audit
An essential element of every healthcare organization’s compliance work plan is the performance of ongoing provider coding and documentation audits. Coding and documentation audits are appropriate for all providers, especially highly productive providers who may find themselves under scrutiny for their billings by area-Medicare administrative contractors and other payers.
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Healthcare Compliance Programs
Healthcare organizations, senior executives, and governing body members are under increasing scrutiny to ensure they have an effective compliance program. The Federal Sentencing Guidelines for Organizations recommends that all organizations have a comprehensive compliance program in place.
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Healthcare Compliance Services
Hospitals, health systems, and physician groups are challenged to keep up with the complicated and ever-changing healthcare regulatory environment. At Coker, we have the compliance solution best suited for your organization to respond to the challenge.
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Healthcare Mergers and Acquisitions Due Diligence
Hospital and physician practice transactions continue as a key growth strategy for healthcare services organizations to extend their footprint for access to care and expand market share competition. With executing mergers, acquisitions, or any other type of transactions involving healthcare entities, due diligent is one of the most critical pieces of a deal process and the likelihood for achieving long-term success.
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HIPAA Compliance
HIPAA compliance is ever-evolving and, although it may seem complicated, your organization is responsible for the protection and security of Patient Health Information (PHI) and Electronic Patient Health Information (ePHI)—even when it’s in the hands of others.
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HIPAA Security Risk Analysis
The Health Insurance Portability and Accountability Act (HIPAA) security rule requires that covered entities conduct an accurate and thorough assessment of risks and vulnerabilities to the confidentiality, integrity, and availability of electronic patient health information (ePHI).
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MACRA/MIPS/APMs
At Coker, we provide consultative assistance related to MACRA/MIPS Implementation to achieve five primary objectives: organizational development, program management, data management, clinician engagement, and auditing and validation.
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Recognized Security Best Practices – 405 (d) Audit
On January 5, 2021, President Trump signed into law H.R. 7898, which amends the Health Information Technology for Economic and Clinical Health (HITECH) Act, requiring the secretary of the US Department of Health and Human Services (HHS) to consider certain recognized security practices when making determinations relating to fines and corrective action plans. If you
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