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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

Healthcare Compliance, Healthcare Technology, audit, healthcare audit, auditor

How to Conduct an Effective Healthcare Compliance Audit

Posted by Donna Thiel on Tue, Sep 05, 2017

Compliance auditing, what a process. There are always so many potential areas to be audited, and often it is difficult to decide where to start. How many different risk areas did you identify when you were working on your compliance plan? Can you possibly audit all of these areas? Did you rate or rank the risks to identify where you have the biggest concerns?

Do you have the resources; time and or people? Do you have the expertise? Do you have an internal audit team or are you using contract auditors? 

How often should you audit? What do you do with the audit findings? I am tired already, and we haven’t even gotten started.  

*Updated from original post on 11/15/2016

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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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