Healthcare GRC Archives

What Are CMS Regulations for Hospitals and How To Stay Compliant

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 ...

By Jacqueline DiChiara|2025-05-15T16:06:51+00:00May 12th, 2025|Governance, Risk & Compliance: GRC, Healthcare GRC|

Watch Current State of Healthcare Compliance Programs: 2025 Benchmark Results

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 ...

By SAI360|2025-05-12T15:06:19+00:00April 18th, 2025|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC|

Watch Current State of Healthcare Compliance Programs: 2025 Benchmark Results (Video)

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 ...

By SAI360|2025-05-07T16:50:41+00:00April 17th, 2025|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC|

How Are HIPAA Breaches Detected? How Healthcare Organizations Catch Privacy Violations

HIPAA compliance remains a critical focus for healthcare organizations. But how are most HIPAA breaches detected? Our 4th Annual HIPAA Compliance Survey reveals that employee reporting remains the primary detection method. However, relying solely on staff to identify breaches may not be enough to protect sensitive patient data and ensure regulatory compliance. HIPAA Privacy Programs: New Compliance Trends to Know Below, we analyze a few ...

By SAI360|2025-04-28T03:07:24+00:00March 24th, 2025|Governance, Risk & Compliance: GRC, Healthcare GRC|

Healthcare Business Continuity and Compliance: 4 Critical Life-or-Death Imperatives

Healthcare business continuity and compliance aren’t just back-office concerns—they’re a lifeline. Literally. When unexpected disaster strikes—a power outage, a cyber incident, or a supply chain disruption—patients’ lives could be on the line. Without a strong healthcare business continuity and compliance strategy, hospitals risk non-compliance, patient safety failures, and operational disruptions. Yet, when it comes to business continuity and disaster recovery (BCDR), too many healthcare systems approach critical healthcare ...

By SAI360|2025-05-09T17:23:49+00:00March 1st, 2025|Governance, Risk & Compliance: GRC, Healthcare GRC|

2025 HIPAA Benchmark Report (pdf)

Thank you for your interest in the 2025 HIPAA Benchmark Report Download Strategic Management Services, in partnership with SAI360, presents a comprehensive look at the current state of HIPAA Privacy Programs through our 4th Annual HIPAA Compliance Survey, conducted in November 2024. This survey, which garnered insights from various healthcare providers across the United States, sheds light on the intricacies of HIPAA program structures, ...

By SAI360|2025-04-28T23:06:13+00:00January 30th, 2025|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

Current State of Healthcare Compliance Programs: 2025 Benchmark Results

Live webinar: Thursday, April 17 1:00 PM ET | 12:00 PM CT | 10:00 AM PT 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 ...

By SAI360|2025-05-07T16:45:17+00:00January 28th, 2025|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC|

New Year, New Conflicts of Interest Strategy: January Compliance Checklist

Conflicts of interest in the workplace happen more often than you might think. A senior manager approves a vendor contract, unaware the vendor employs a family member. An employee fails to disclose a financial interest in a competitor’s business, creating a potential bias in decision-making. These are just two examples of how conflicts of interest can quietly develop in the workplace. All while exposing organizations ...

By SAI360|2025-04-28T03:03:43+00:00January 13th, 2025|Ethics & Compliance Learning, Governance, Risk & Compliance: GRC|

The Time is Now to Start Breaking Silos in Healthcare: Why Integrated Risk Management is Essential

The following article on risk management in healthcare is part of our ongoing series, CustomerConnect Insights: The Future of Ethics, GRC, and Training. This series brings together expert perspectives and actionable strategies from SAI360’s CustomerConnect events, focusing on the latest advancements, challenges, and innovations. The goal? Help organizations strengthen their approach to risk, compliance, and continuous learning in an evolving landscape. Why Is Integrating Risk Management Across Domains ...

By SAI360|2025-04-28T02:58:54+00:00November 13th, 2024|Governance, Risk & Compliance: GRC, Healthcare GRC|

Watch Strategies for Addressing Medicare Advantage Denials, Downgrades, and Disputes

Medicare Advantage plans continue to present challenges with frequent denials, downgrades, and disputes—the "3 D's." It’s time to shift from a reactive stance to a proactive approach by mastering the regulations and turning denials into actionable strategies. In this recorded webinar Day Egusquiza, President of AR Systems Inc., shares her expertise on effectively responding to Medicare Advantage denials by leveraging regulations to confidently reject unjust ...

By SAI360|2025-05-07T17:56:56+00:00November 8th, 2024|Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

What Are CMS Regulations for Hospitals and How To Stay Compliant

Watch Current State of Healthcare Compliance Programs: 2025 Benchmark Results

Watch Current State of Healthcare Compliance Programs: 2025 Benchmark Results (Video)

How Are HIPAA Breaches Detected? How Healthcare Organizations Catch Privacy Violations

Healthcare Business Continuity and Compliance: 4 Critical Life-or-Death Imperatives

2025 HIPAA Benchmark Report (pdf)

Current State of Healthcare Compliance Programs: 2025 Benchmark Results

New Year, New Conflicts of Interest Strategy: January Compliance Checklist

The Time is Now to Start Breaking Silos in Healthcare: Why Integrated Risk Management is Essential

Watch Strategies for Addressing Medicare Advantage Denials, Downgrades, and Disputes

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