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CORPORATE INTEGRITY AGREEMENTS – AN OFFRAMP ON THE ROAD TO EXCLUSION

July 5, 2021

When a health care entity is faced with permissive exclusion from participation in federal health care programs, the Health and Human Services Office of Inspector General (OIG) has the discretion to offer a Corporate Int...

FEDERAL COVID-19 FRAUD CRACKDOWN – FULL SPEED AHEAD IN 2021

June 28, 2021

Beginning in 2021, both the HHS OIG and the DOJ have leveraged their resources to focus to the fraud and abuse schemes against federal health care recipients and programs related to the COVID-19 pandemic. As the pandemic...

Appealing an OIG Exclusion

June 21, 2021

Every year, hundreds of health care providers and entities receive notification from the HHS OIG that they are being considered for exclusion from participation in federal programs. To date in 2021, 684 individuals and e...

UPDATED: The New Relevance of the Death Master File

June 14, 2021

The first COVID-related federal stimulus payments were sent in the spring of 2020. Unfortunately, payments were sent to millions of taxpayers who were deceased at the time of payment. Not only did this draw attention ...

Licensure Verification

June 7, 2021

Introduction For most health care organizations, their primary purpose is to provide high quality patient care to support the best outcomes possible.  The qualifications and expertise of an organization’s medic...

MANAGING THROUGH AN EXCLUSION BY THE OIG

June 1, 2021

AN OVERVIEW of THE OIG’S LIST OF EXCLUDED INDIVIDUALS AND ENTITIES Since 1977, the federal government has maintained a list of individuals and entities that are excluded from participation in any federal health care...

THE IMPORTANCE OF SANCTION SCREENING TO YOUR ORGANIZATION

May 19, 2021

What Is A Sanction Check Sanctions against medical personnel can create significant risk to a healthcare organization from financial, compliance and patient safety perspectives. Therefore, it is critical that organiz...

NPI Numbers Enhancing the Exclusion Screening Process

May 14, 2021

Last month, the OIG released  audit report findings regarding whether Medicare Part C health plans (also known as Medicare Advantage Organizations or MAOs) are fully utilizing National Provider Identifier numbers (N...

Fraud in the time of the Coronavirus Pandemic

May 10, 2021

Along with significant scientific and medical challenges, COVID-19 has also revealed significant fraud-related challenges. Some are novel and some are variations on age old schemes. This article addresses Coronavirus fra...

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