Introduction to Healthcare Compliance

This module introduces the foundational principles of healthcare compliance, the Seven Elements of an Effective Compliance Program, major fraud and abuse laws, and the critical role of leadership in building a culture of compliance. 

Recommended Use: Required
ID (Language): English (22419)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module covers the Federal Sentencing Guidelines, the False Claims Act (including reverse false claims and the 60-day overpayment rule), self-disclosure protocols, and the federal exclusion process.

Recommended Use: Required
ID (Language): English (22420)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module explains how Medicare billing and reimbursement work, including the revenue cycle, National Provider Identifier (NPI) responsibilities, accepting assignment, overpayment rules, common billing risks, and the role of technology and artificial intelligence in preventing errors.

Recommended Use: Required
ID (Language): English (22421)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module provides an in-depth examination of the Anti-Kickback Statute and the Stark Law, including prohibitions, differences, exceptions/safe harbors, and practical compliance strategies.

Recommended Use: Required
ID (Language): English (22422)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module covers the practical application of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules, protected health information (PHI), permitted uses and disclosures, key exceptions, and the Health Information Technology for Economic and Clinical Health (HITECH) Act’s breach notification requirements.

Recommended Use: Required
ID (Language): English (22423)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module explains how a code of conduct, written policies and procedures, and targeted education and training work together to create and maintain a strong culture of compliance for employees and clinicians.

Recommended Use: Required
ID (Language): English (22424)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module focuses on conducting compliance risk assessments, developing and using a risk matrix, distinguishing between auditing and monitoring, and understanding audit requirements under corporate integrity agreements.

Recommended Use: Required
ID (Language): English (22425)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module focuses on how healthcare organizations should investigate potential compliance violations, report them to the government when required, conduct root cause analyses, and implement effective corrective actions to prevent recurrence.

Recommended Use: Required
ID (Language): English (22426)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module examines external federal and state enforcement agencies and internal enforcement tools, including disciplinary consequences for noncompliance and incentives to promote compliant behavior.

Recommended Use: Required
ID (Language): English (22427)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law

This module covers the unique compliance requirements in clinical research, including clinical trial definitions, regulatory oversight, Medicare billing rules for research participants, coverage analysis, and key risks in research-related billing.

Recommended Use: Required
ID (Language): English (22428)
Author(s): Janis Anfossi, JD, MPH - Loyola University Chicago School of Law