Risk Management Consulting for Home Health/Hospice Agencies

Risks Facing Hospices & Home Health Agencies

Compliance with Stark Law & Anti-Kickback Statute

Home health/hospice care providers must comply with the Stark Law & Anti-Kickback Statute. These regulations make it illegal for medical providers to receive or pay kickbacks or related financial compensation for patient referrals involving patients who get treatment paid by government programs like Medicare and Medicaid. Hospices and home health agencies risk fines and other legal consequences like imprisonment.

We can assess compliance with Stark Law and Anti-Kickback Statute among other regulation to protect your organization from fines and legal action.

Put our highly experienced team on your side

Roger Bach
Roger Bach

Former Special Agent
(DOJ-OIG & DEA)

Timothy E. Allen
Timothy E. Allen

Former Senior Special Agent
(U.S. Secret Service & DOJ-OIG)

Chris Quick
Chris Quick

Former Special Agent
(FBI & IRS-CI)

Maura Kelley
Maura Kelley

Former Special Agent
(FBI)

Ray Yuen
Ray Yuen

Former Supervisory Special Agent
(FBI)

Michael Koslow
Michael Koslow

Former Supervisory Special Agent
(DOD-OIG)

Marquis D. Pickett
Marquis D. Pickett

Special Agent
U.S. Secret Service (ret.)

Dennis A. Wichern
Dennis A. Wichern

Former Special Agent-in-Charge
(DEA)

Documentation Risks

Healthcare providers need specific documentation to demonstrate medical necessity and meet other requirements i.e., Medicare licensing requirements. We assess a home health/hospice care provider’s documentation needs to avoid operational risks. Claims that don’t demonstrate medical necessity can be declined and lead to unexpected losses.

Our risk management consulting experts understand all documentation needs for hospices & home health agencies operating in the U.S. We can sensitize your staff on all documentation risks.

HIPAA Risks

Since 1996, healthcare providers have been subjected to HIPAA guidelines. The regulations are meant to simplify healthcare administration, prevent healthcare fraud, eliminate wastage and offer other benefits. HIPAA regulations now include patient privacy protections that ensure patient data and privacy is protected.

HIPAA regulations are lengthy and contain many provisions making it incredibly easy for hospices and home health agencies to violate the rules. That’s where we come in. Considering violations attract hefty penalties that can surpass a million dollars and other risks such as jail term of up to ten years, providers in the healthcare sector must take HIPAA guidelines seriously.

Corporate Investigation Consulting has HIPAA violation experts that understand everything about HIPAA, from conducting risk analysis to handling protected health information. We can ensure compliance with small guidelines such as those on sharing protected health information online, texting such information, encrypting protected health information, and more.

Call us now – 866-352-9324 to get risk management consulting services on HIPPA and other risks facing home health/hospice care providers.

Quality of Care Risks

Internal audits can cover quality of care issues in healthcare provider services resulting in fines, legal suits, and other unfavorable occurrences. To avoid such risks, home healthcare agencies and hospices need to assess their services proactively.

Our experts can check for inadequate care and unqualified personnel risks. We can do background checks and assess facilitates, procedures, and other aspects to uncover issues before regulators or investigations. Request for our FREE initial risk management consultation now: 866-352-9324.

Billing Risks

Healthcare providers like home healthcare providers are susceptible to ACA risks. The ACA (Affordable Care Act) requires persons receiving overpayment from any defined government healthcare programs to report such occurrences and return overpayment within 60 days.

We can assess and handle ACA risks, among other risks for providers, to avoid FCA (False Claims Act) penalties.

Our Risk Management Consulting Process

Risk Assessment

Hospices and home healthcare providers face evolving regulations and constant scrutiny from regulators. To cope with constantly changing threats, the importance of assessing risk can’t be overlooked.

We begin by evaluating the risk profile to discover the potential impact on a hospice/home healthcare provider’s objectives and vulnerabilities. We’ve designed our risk assessment process to understand potential threats and gaps in an organization’s objectives.

Our experts assess risk from a site level, locally and globally. The process also focuses on both simple and complex risks to allow the design of optimal risk management approaches that offer competitive advantage.

Our risk assessments can be used for compliance purposes. As healthcare regulations evolve, hospices, home healthcare agencies, and other healthcare players must identify compliance risks and threats/gaps existing in their organizations. Our risk assessments identify variable and structural risks.

Risk assessment also identifies duty of care risks. We can give you insights and offer oversight where processes in your hospice or home health agency don’t meet standard of care guidelines. Risk assessment also identifies future internal and external risks and their impact on your organization. We can assess risks like economic influence, cybersecurity risks, supply chain risks, natural disasters, and more.

Risk Indexing

Our risk assessments assess an organization’s risk profile. Risk indexing monitors risk. Risk indexes and scores offer a base for security protocols. This service will give your organization procedural guidelines.

With reports and other tools like dashboards in place, hospice/home healthcare providers can make better knowledge-based decisions. Our reports have unmatched detail to ensure our customers understand the unique risks they face.

Our risk management consulting experts are highly skilled in using risk management technology to make the process accurate, effective, and understandable. Our statistical methodologies can accurately predict threats making it easy to mitigate risks and achieve business goals.

For more on how we manage risk, call 866-352-9324.

Choosing the Right Risk Management Consulting Experts for Your Hospice/Home Health Agency

Since fraud, billing risks, HIPAA risks, quality of care risks, among other risks affecting hospices are inevitable and attract serious consequences, it’s important to choose the right risk management consultants.

To avoid jail time, hefty fines, reputation damage, and other problems, you need a risk management consulting firm that can assess risk, identify all possible risk, and provide risk mitigation measures. The best U.S. risk management consulting experts can be differentiated by:

Familiarity with Rules and Regulations

Hospice/home healthcare owners who want risk management services don’t have time explaining the basics to consultants. As a result, choose consultants who already understand certification, billing, coding, and other regulations applicable to healthcare providers in the U.S.

Corporate Investigation Consulting has consultants who know everything there is to know about regulatory compliance for healthcare providers. Check out professional profiles of our corporate investigation consultants here.

Proven Record

A good professional profile isn’t enough. You need risk management consultants proven to resolve all manner of risk management issues from healthcare fraud and internal/external audit issues to lawsuits on compliance and other issues involving federal agencies like the DOJ, OIC, & IRS.

Nationwide Coverage

It also helps to hire risk management consultants who have nationwide presence. Corporate Investigation Consulting can handle risk management issues in all states. Our experts understand state regulations affecting healthcare providers in multiple jurisdictions.

Claim a free-confidential initial consultation now. Try us to assess our capabilities. Contact us or call us at 866-352-9324.

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