Centers for Medicare & Medicaid Services (CMS) regulations for hospitals and other healthcare organizations define the federal requirements providers must follow to receive Medicare and Medicaid reimbursement. These rules govern patient safety, billing accuracy, infection control, privacy, and electronic health records (EHRs). Conditions of Participation (CoPs) refers to the specific health and safety standards organizations must maintain. Additionally, hospitals also closely monitor regulations related to ...
What are the biggest risks companies are facing right now worldwide? They are cyber incidents, operational disruptions, and climate-driven disasters. None are surprises. As organizations push forward with digital transformation and global expansion, they’re continually finding themselves more exposed. The systems they rely on are, in the meantime, becoming more complex. And they need to be. The stakes are higher. Business continuity is now about ...
The PowerSchool data breach has become a defining example of third-party risk failure in education and EdTech. It's a harsh wake-up call for ethics, Governance, Risk, and Compliance (GRC) teams. What Caused This Data Breach? On December 28, 2024, PowerSchool confirmed a compromised credential had been used to access its PowerSource customer portal—a system that supports school staff across 17,000 districts and serves over 55 ...
The CPS 230 APRA standard represents one of the most significant shifts in how Australian financial institutions manage operational risk. Introduced by the Australian Prudential Regulation Authority (APRA), CPS 230 is designed to strengthen resilience by improving oversight, risk visibility, and accountability across critical operations. This standard moves beyond reactive risk management. It encourages a culture of preparedness and clarity. And it ensures organizations are compliant ...
Live Webinar: Friday, June 13 Time: 1:00 PM ET| 11:00 AM CT | 10:00 AM PT In this webinar, Day Egusquiza, President of AR Systems Inc., returns to address the persistent challenge of healthcare denials through a practical two-step framework. Building on her previous insights on Medicare Advantage challenges, this session offers concrete strategies to transform your organization's approach to denials management. Step 1: Data-Driven ...
The U.S. Department of Justice (DOJ) has long emphasized the importance of effective corporate compliance programs. While enforcement priorities may shift over time, the core expectations outlined in DOJ guidance remain consistent: programs must be well-designed, applied in good faith, and actually work in practice. What does that look like in real terms? First, programs must reflect the unique risks of the organization. There’s no ...
Enterprise risk assessments (ERA) and business impact assessments (BIA) are the heart of operational resilience. Both are foundational to managing risk. Each plays a distinct role in helping companies navigate uncertainty. But they are not interchangeable. What’s the difference? ERA is about prevention. BIA is about recovery. What is an Enterprise Risk Assessment? An ERA takes a wide-angle lens to risk. It’s designed to identify and prioritize ...
Regulatory change continues to challenge organizations worldwide. From the UK's Digital Services Act and the EU's Cyber Resilience Act to the U.S. Corporate Transparency Act, businesses must continuously pay close attention to ongoing local and global regulations. With escalating ESG disclosure mandates, increasing AI governance, and a surge in enforcement actions, the volume of new requirements—and the speed at which they hit—is forcing companies to rethink how ...
Current State of Healthcare Compliance Programs: 2025 Benchmark Results For the sixteenth year in a row, SAI360 partnered with Strategic Management Services to study the state of healthcare compliance programs in an industry benchmark survey of programs in the United States. This annual survey is designed to gain an understanding of issues currently confronting compliance programs and how compliance officers and organizations are responding to ...
For the sixteenth year in a row, SAI360 partnered with Strategic Management Services to study the state of healthcare compliance programs in an industry benchmark survey of programs in the United States. In this webinar, former HHS Inspector General, Richard Kusserow, CEO of Strategic Management Services, reports on the results and provides analysis of the data from the survey, including important trending and cumulative ...
