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The ProviderTrust Blog

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

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, OIG Work Plan, compliance program

July OIG Work Plan Updates

Posted by Michael Rosen, ESQ on Thu, Jul 27, 2017

As of June 2017, the Office of Inspector General (OIG) began providing updates to their Work Plan on a monthly basis. This will help compliance professionals update their plan or make sure they are continuing to focus on the most current OIG priority areas. The online updates will allow direct access to providers and other visitors.

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Industry News, Medicare, Fraud and Abuse

Chicago U.S. Attorney's Office Creates New Healthcare Fraud Unit

Posted by Michael Rosen, ESQ on Wed, Jul 26, 2017

The Chicago U.S. Attorney's Office is creating a new unit to prosecute healthcare fraud. Assistant U.S. Attorney Heather McShain will lead the team of five prosecutors. The team brings local focus on combatting fraud in Medicare, which has been a national priority for the U.S. Department of Justice (DOJ) for nearly a decade.

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Healthcare Compliance, OIG, corporate integrity agreements

Settlement Considerations: CIA or No CIA?

Posted by Harold Malkin on Fri, Jul 21, 2017

We are pleased to welcome a guest today on the blog - Harold Malkin, a former Assistant U.S. Attorney who specialized in the resolution of civil healthcare fraud cases involving individual providers, medical practices and institutional providers in the Western District of Washington in Seattle for over 15 years. In this article, Harold will highlight some important information regarding the permissive and mandatory exclusion authority of the Office of Inspector General (OIG) as well as some things to consider if you find yourself in settlement discussions with OIG.

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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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