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The ProviderTrust Blog

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

OIG, License Verification, Compliance Plan

You Can't Afford Not to Monitor Healthcare Licenses and Sanctions

Posted by Michael Rosen, ESQ on Thu, Aug 10, 2017

“An ounce of prevention is worth a pound of cure.” At least that is what Benjamin Franklin said a century ago. He is right, and that was insightful - even before his face would appear on U.S. currency. Little did he know how many “Benjamins” it would cost a healthcare company in fines for non-compliance with licenses.

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Industry News, OIG, Fraud and Abuse

OIG Focuses on Combatting Home Health Fraud and Neglect

Posted by Michael Rosen, ESQ on Tue, Aug 08, 2017

Ohio had their hands full in a federal case involving a former home healthcare nurse who committed heinous crimes and Medicaid fraud involving a severely physically disabled 14-year-old minor (cerebral palsy) in her care. As a result of her neglect and fraud, she also received a lifetime ban from working in any governmental entity in the healthcare field.

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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, 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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