Referrals from Excluded Providers

January 18, 2021

Hospitals and other health care providers typically rely on referrals from community providers as a major source of patients and revenue. The federal Stark and Anti-Kickback laws strictly regulate provider and facility a...

Differences Between the OIG’s LEIE and GSA’...

January 11, 2021

INTRODUCING THE OIG LEIE & the GSA’s SAM Database It is the government’s responsibility to protect its health and human services programs from fraud and abuse, as well as to safeguard the welfare of those who ...

COVID-19 Health Care Changes that May Survive the ...

January 4, 2021

The COVID-19 pandemic has changed the face of the health care industry on multiple fronts. These range from the multiple blanket 1135 temporary waivers issued by CMS that control how care for federal program beneficiarie...

Understanding Waivers & the Duration of OIG Exclusions

December 28, 2020

Exclusion Background As noted in past blog posts, HHS OIG Exclusions are comprehensive and significant. Exclusion from participation in federal healthcare programs can have a profound effect on a provider’s healthcare...

Survey and Accreditation Activities in the Age of ...

December 21, 2020

As the first vaccines are delivered across the US, we can begin to look forward to a post-pandemic future and resuming routine activities that have been sharply curtailed in 2020.  This includes the resumption of the fu...

Pandemic-Related Waivers by CMS and the Continued Importance ...

December 14, 2020

COVID 19 has resulted in a flurry of waivers by federal and state regulatory agencies related to the provision of health care for Medicare and Medicaid patients. The CMS blanket waivers (issued as “1135 waivers” unde...

Nursing Board License Actions – OIG & Medi-Cal Exclusions

December 7, 2020

Nurses and other health care providers must meet certain ethical standards in order to maintain their licenses. For example, in California, Welfare and Institutions Code §14043.6 and 14123, mandate that the Department o...

Exclusion Screening & the Affordable Care Act

November 30, 2020

If the Affordable Care Act (ACA) is repealed – the potential effect on program integrity protections remains unclear. Over the last few years, the effect of an ACA repeal on health care and health plan coverage has ...

Streamline Verify helps launch largest Single COVID-19 Plasma ...

August 18, 2020

Streamline Verify considers itself fortunate to be running without incident throughout the COVID-19 pandemic due to the nature of its business. However, they have seen firsthand many of their own clients who are all heal...

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