Why Do Some Nurses Commit Fraud?

June 28, 2016

Nurse Fraud   Nurses have become heavily involved in a spate of health-care related fraud news in recent years. One of the most controversial reports of fraud from the Department of Justice was in 2011, which inv...

The Fraud That Binds?

June 20, 2016

Just a few months into 2016, and already, a mother-daughter tandem is causing ripples in the health care pond by pleading guilty to second-degree Medicaid fraud in Hawaii last March 9.   The “mother” in this c...

Compliance Officers and the HR Department

June 14, 2016

The Differences between Compliance Officers and the HR Department   The HR department of any organization has a crucial role to play in ensuring compliance, and company compliance officers have the important res...

Texas OIG and Medicaid Exclusions

June 6, 2016

Texas OIG and Medicaid Exclusions Under the guidance of Inspector General Stuart W. Bowen, Jr., Texas OIG functions within a singular mission: " To detect, prevent, and deter fraud, waste, and abuse through the audit, i...

Exclusion Screening VS. Fragmented Databases

May 30, 2016

Is Exclusion Screening even possible? The U.S. Government Accountability Office has recently released the results of a study conducted in order to gauge the reliability, uniformity, and exhaustibility of exclusion databa...

Daniel Levinson’s Parthenon of Compliance

May 18, 2016

The Parthenon of Healthcare Compliance   https://youtu.be/5TQg1A3ovRA   At the 2016 HCCA Compliance Institute, an annual conference for compliance stakeholders, Inspector General of the U.S. Department of H...

FDNY Medicare Fraud

May 10, 2016

  The Frightening Reaches of Healthcare Fraud The U.S. public healthcare system loses approximately $60 billion annually to medical fraud. This disconcerting figure, which could have gone to better use and could h...

Permissive Exclusions Updates from the OIG to 1128(b)(7)

May 2, 2016

Recently on April 18, 2016, the Inspector General of the famed OIG issued a review and updates on their exclusion policies and how they go about permissive exclusions. The OIG was established back in 1976 in order to p...

NY Medicaid Exclusion

April 14, 2016

  New York State Medicaid Exclusion New York’s Office of the Medicaid Inspector General exists to “to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusive, and...

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