Mar 28, 2024 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce the release of the HHS OIG Completed Audits March 2024 Update. Every year, the HHS OIG Office of Audit Services and Office of Evaluation and Inspections conducts about 300 audits and evaluations. These activities are...
Mar 26, 2024 | Healthcare Compliance
Is your audit season soon? Is your audit season soon? Here’s a friendly reminder. In December, CMS sent a memo about the 2024 program audit updates slated for the upcoming audit season. Medicare Advantage and Medicaid plans should have been reminded of the April 2023...
Feb 27, 2024 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce the February 2024 updates to its HHS OIG reports. Every year HHS OIG Office of Audit Services and Office of Evaluation and Inspections conducts around 300 audits and evaluations. The OIG Work Plan outlines different...
Feb 2, 2024 | Healthcare Compliance
SunHawk Consultng is pleased to announce Dave Fairburn and Jennifer McCallister’s Case Study in Security Focus and Execution: “Getting a Thumbs Up from the Agency CISO”. The study will be presented virtually at SCCE Government Contracting Compliance...
Feb 2, 2024 | Healthcare Compliance
In January 2024, the IIA released an update to the International Professional Practices Framework, including new Global Internal Audit Standards. In this session, you will gain insights into the new Standards from James Rose, a member of the International Internal...
Jan 31, 2024 | Healthcare Compliance
The United States Government requires Corporate Integrity Agreements (CIA) for health care Providers, Payers and Life Science companies when settling allegations of false claims related to quality of care or corporate integrity issues, against various Federal health...
Oct 25, 2023 | Corporate Investigations, Healthcare Compliance
Our experts – James Rose, Martin Biegelman, and Nancy Roht – had a fantastic time speaking at this year’s HCCA Board & Audit Committee Compliance Conference! The SunHawk team would like to thank the HCCA and all the attendees who made the conference a...
Oct 19, 2023 | Corporate Investigations, Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that three of our experts – James Rose, Martin Biegelman, and Nancy Roht – will be presenting at the HCCA Board & Audit Committee Compliance Conference on October 23rd and 24th, 2023. THE...
Oct 16, 2023 | Healthcare Compliance
Interested in advancing your audit skills and developing an audit engagement scope? SunHawk Managing Director James Rose, along with Sara E. Coverstone, Chief Compliance & Privacy Officer, Northern Arizona Healthcare, are presenting at HCCA on October 19!...
Oct 9, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Lorraine Aniello and Leah Lane will be presenting on the topic of “A Case Study in Consequences of Insufficient Due Diligence in Medical Practice Acquisition” at the Clinical Practice...
Sep 1, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Managing Director, James Rose will be presenting at the 2023 September Auditing & Monitoring Conference on September 6, 2023 The presentation will be a case study on AUDITING CONTROLS VERSUS TRANSACTIONS You Will...
Aug 23, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Lorraine Aniello and Leah Lane will be presenting on the topic of “A Healthcare Study in Fraud and Collaboration with Clinical and Medical Coding Teams” at the Clinical Practice Compliance Conference,...
Jul 13, 2023 | Healthcare Compliance
In our previous article, we explained how Risk Adjustment is a “partnership” between the patient, the provider, the insurance plan (Plan), and the governmental entity. So, which partner in this process holds the “risk”? Governmental Entity: The governmental entity has...
Jul 5, 2023 | Healthcare Compliance
Under the risk adjustment (RA) model, reimbursements to the insurance companies (Plans) are based on the member’s level of severity of illness rather than the number and types of interventions the member receives throughout the year. This reimbursement model is based...
May 2, 2023 | Healthcare Compliance
This article, as part of the SunHawk Consulting team’s Medical Risk Adjustment compliance as well as statistical sampling & coding audit services, gives a high level overview of some upcoming changes for 2024 in the CMS Risk Adjustment model, V28. The CMS-HCC Risk...
