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The ProviderTrust Blog

Your source for healthcare compliance news, advice from industry experts, and all things related to OIG exclusions.

Donna Thiel

Recent Posts

Industry News, Fraud and Abuse, department of justice

New DOJ Opioid Fraud and Abuse Detection Unit Created

Posted by Donna Thiel on Thu, Aug 17, 2017

Throughout the year, the Office of Inspector General (OIG), as well as the Department of Justice (DOJ) and President Trump, have made it clear that opioid abuse is a primary area of focus for government agencies. In a recent announcement, Attorney General Sessions showed that the government isn’t just talking- they are taking action. On August 2nd, Attorney General Sessions announced the formation of the Opioid Fraud and Abuse Detection Unit. This new unit of the DOJ will be a pilot program to utilize data to help combat the opioid crisis.

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CMS, Compliance Plan, SNF Requirements

CMS Delays SNF Penalties for Phase 2

Posted by Donna Thiel on Fri, Aug 04, 2017

On June 30, the Center for Clinical Standards and Quality/Survey & Certification Group issued a memorandum outlining revisions to the State Operations Manual (SOM) Appendix PP for Phase 2, F-Tag revisions, and several other related issues specific to the Requirements of Participation of nursing centers. The new CMS mandates include the minimum health and safety standards that skilled nursing facilities must meet to participate in Medicare and Medicaid.

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Industry News, Medicaid, Data Management

New Mexico Takes Aim at Medicaid Fraud and Abuse

Posted by Donna Thiel on Tue, Aug 01, 2017

New Mexico’s Attorney General Hector Balderas takes Medicaid fraud very seriously, and late last week announced several new initiatives to weed out Medicaid fraud in his state. For the first time in New Mexico’s history, the Attorney General has requested and received a waiver from the federal government to allow the Office of the Attorney General to proactively search through data to identify patterns of fraud.

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OIG, Fraud and Abuse, Compliance Plan, exclusion monitoring

OIG Continues Focus on Skilled Nursing Facilities

Posted by Donna Thiel on Tue, Jul 18, 2017

Like most compliance officers, I receive compliance updates in my inbox every day from various vendors, compliance organizations, and of course the Office of Inspector General and Department of Justice. I always make sure to read all of the recent government settlements but maybe because of my background and love for the post-acute sector, I continue to notice how frequently the OIG and DOJ focus on the post-acute sector, and often more specifically on skilled nursing facilities.

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Healthcare Compliance, OIG, OIG Exclusion

Quick Guide to the OIG Self-Disclosure Protocol

Posted by Donna Thiel on Fri, Jun 30, 2017

You found an excluded employee in your organization, now what? Likely, your first thought is a bit of panic and a lot of questions. How long has this person worked for us? How did we miss this? What position did they hold? Did we receive federal funds for the job this person held? What do I do now? If there is any good news in this scenario, perhaps it is that the Office of Inspector General (OIG) has given providers direction on how to prepare for a self-disclosure to the OIG via the OIG’s Provider Self-Disclosure Protocol (SDP) document.

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