Managed Care

Annual Compliance Education

  • 1.  Annual Compliance Education

    Posted 03-22-2018 07:35 AM
    Hi Everyone,

    I recently began working with my MCO about 6 months ago and was recently tasked with overseeing our education activities. I have worked in provider compliance for close to 9 years before I made this switch. From what I have seen on the payor side, it appears that there is quite a lot of education that is required vs. ad-hoc. Am I off? Can anyone provide me  with a list of compliance education topics that are covered at your organizations? I just want to know if what I am seeing can be combined to become more efficient and less taxing on the organization. THoughts and comments are always appreciated.

    Thank you,



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    Luis Jusino CHC,CHPC
    Manager of Compliance and Audit
    Healthfirst
    ljusino@healthfirst.org
    Hyde Park,NY
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    2019 HCCA Compliance Institute


  • 2.  RE: Annual Compliance Education

    Posted 03-22-2018 10:01 AM
    We require HIPAA Privacy and Security training as well as Fraud, Waste, and Abuse, to comply with regulations for HIPAA and Medicare.

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    Carl Russell
    Compliance Analyst
    Delta Dental of Idaho
    Boise,ID

    Anything I say is my sole opinion and not of my company.
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    2019 HCCA Compliance Institute


  • 3.  RE: Annual Compliance Education

    Posted 03-23-2018 07:40 AM
    We require Compliance & HIPAA training which includes information on the laws (e.g. FCA, DRA, Anti-kickback, CMPL, Whistleblowers, HIPAA, State privacy laws, HiTech, etc.). We also provide information on the seven elements of compliance, breach notification, safeguarding PHI & ePHI, FWA, billing requirements, documentation requirements & ethics.

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    Cynthia Liu Bingaman, MA, LBSW, CHC
    Director of Regulatory Compliance/Privacy Officer
    BMHA
    Benton Harbor,MI
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    2019 HCCA Compliance Institute