Cost:

Free for HFMA Members
Buy HFMA Membership to Attend

Audience:

Hospitals and Other Providers
Business Partners
Health Plans
Physicians and Other Practitioners

Advance Preparation:

None

Prerequisites:

None

Course Availability:

18 Months

Course | Overview | Compliance
In this course, you will follow a patient from admission to discharge, stopping along the way to see how everyone in a hospital, including the patient, is affected by HIPAA.<div><br></div><div>Estimated course completion time: 30 minutes</d...
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News | Compliance
Although proposed Stark Law exceptions have drawn praise in comments from many healthcare stakeholders, others see reasons for caution.
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On Demand Webinar | Basic | Compliance
In 2018, the Centers for Medicare and Medicaid Services released the CY 2019 Revisions to Payment Policies under the Physician Fee Schedule and other Revisions to Medicare Part B, which included policies related to Medicare Quality Payment ...
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Course | Overview | Compliance
This course explains the qui tam provisions under the False Claims Act, and the different ways in which a qui tam action may proceed. The course also explains the potential awards available to relators in qui tam actions.<div><br></div><div...
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Course | Overview | Compliance
This course addresses the rise of corporate compliance programs in healthcare organizations, including their complexity and importance. It reviews the components of corporate compliance programs and the role of a compliance officer to know ...
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Course | Overview | Compliance

Healthcare Industry Regulation and Accreditation

Course | Overview | Compliance

Healthcare Industry Regulation and Accreditation

Description

This course discusses the regulation and accreditation of the healthcare field. It provides overviews of various legislation, such as the HMO Act of 1973, the Employee Retirement Income Security Act of 1974 (ERISA), state regulations, and the Patient Protection and Affordable Care Act (PPACA). It also discusses regulatory and crediting bodies, including the Joint Commission, URAC, and the National Committee for Quality Assurance (NCQA).

Estimated course completion time: 1 hour
After this program, you'll be able to..
  • Recognize changes in the focus of healthcare regulation over the last 20 years
  • Recognize recent efforts by CMS to monitor and recover improper reimbursement
  • Provide a general description of The Joint Commission
  • Identify the several types of organizations for which The Joint Commission provides evaluation and accreditation services
  • Recognize why the HMO Act of 1973 was deemed necessary
  • Name some of the financial guidelines established by the HMO Act of 1973
  • Recognize the National Association of Insurance Commissioners HMO Examination Handbook
  • Identify some types of state regulations that deal with HMO solvency
  • Recognize why ERISA was deemed necessary
  • Identify the types of organizations and health benefit issues that are governed by ERISA
  • Recognize how ERISA may preempt state regulations
  • Recognize why prompt payment regulations were deemed necessary
  • Provide a general description of prompt payment regulations
  • Identify the types of organizations that are exempt from prompt payment regulations
  • Recognize why COBRA was deemed necessary
  • Recognize the regulations established by COBRA
  • Recognize the purpose of EMTALA
  • Identify the actions required by hospitals to be in compliance with EMTALA
  • Recognize the purpose of URAC
  • Name several of the accreditation programs offered by URAC
  • Recognize the major provisions of HIPAA
  • List some changes to HIPAA privacy laws included in ARRA
  • Identify the types of information collected and disseminated by HIPDB
  • Recognize changes to HIPDB that were implemented in 2004
  • Briefly define QISMC's standards and guidelines
  • Define EHRs and list information included in them
  • List the two main issues to consider when discussing the safe use of EHRs
  • Recognize the potential results of EHRs' emphasis in providing one standardized clinical data structure and presentation
  • Recognize the purpose of NCQA
  • List and briefly describe the six areas covered by an NCQA review
  • Recognize the purposes of PPACA
  • Identify the major provisions of PPACA

Related Courses | Compliance

Course | Overview | Compliance

A Day in the Life of a Patient: A HIPAA Review

In this course, you will follow a patient from admission to discharge, stopping along the way to see how everyone in a hospital, including the patient, is affected by HIPAA.


Estimated course completion time: 30 minutes

Course | Basic | Patient Access

Advance Directives and Bedside Registration

This course describes the types of advance directives and explains the role of the registrar in identifying the existence of advance directives and processing such directives when they exist. It describes the specific challenges involved in registering patients at the bedside and discusses express or mini registrations, as well as "Jane/John Doe" registrations. This course explains how patient access staff should interact with emergency patients to avoiding violating the Emergency Medical Treatment and Active Labor Act (EMTALA).


Estimated course completion time: 30 minutes

Certification | Overview | Physician Practice Revenue

Certified Specialist Physician Practice Management Recertification

The CSPPM recertification program is recommended for active, eligible, HFMA CSPPM certificants with an upcoming maintenance due date of May 31, 2020. Not sure when your CSPPM expiration date is? Sign in, click your profile image in the upper right corner, select My Development, and then click on the Certifications tab near the center of your page. You'll see your certifications along with their expiration date.

HFMA requires that eligible CSPPM certificants gain competence in the physician practice management arena by taking a short assessment every two years. This program provides healthcare organizations with a means to ensure that their staff has the body of knowledge necessary to meet their demands.

CSPPM recertification course outline:

  • Encounter Processing
  • Accounts Receivable: Collections, Policy, and Evaluation
  • Budgeting and Benchmarking
  • Integrated Health Systems and Managed Care

Assessment information:
This online program includes the above recertification courses and a recertification assessment. The assessment has 50 multiple choice questions and you have 90 minutes to complete it in one sitting. The passing score is 70%. If you do not pass on the first attempt, there is a mandatory 30-day waiting period. Please keep this in mind, as the deadline to complete the recertification assessment (to maintain your certification) is May 31, 2020.

On Demand Webinar | Basic | Compliance

What does the CMS Quality Payment Program (QPP) final rule mean for me

In 2018, the Centers for Medicare and Medicaid Services released the CY 2019 Revisions to Payment Policies under the Physician Fee Schedule and other Revisions to Medicare Part B, which included policies related to Medicare Quality Payment Program (QPP).

Clinicians have two tracks to choose from in the QPP based on their practice size, specialty, location, patient population, and Alternative Model participation: 1.) Merit-based Incentive Payment System (MIPS) or 2.) Advanced Alternative Payment Models.

This webinar will focus on the requirements of physicians' involvement in the QPP and their reimbursement ramifications of participation. Physicians will be made aware of their current participation level and how this will affect their practices and continued improvement of care delivered to patients.