The ProviderTrust Blog.
Simplifying healthcare compliance.

A Bunch of Bad Apples Keep Home Health Agencies Away

Posted by Mike Rosen on Fri, Feb 07, 2014 @ 08:58 AM

It pays to play nice and when others don’t, CMS can put a big bite in the potential for new Medicare and Medicaid providers. If this is news to you, it is to most people. 

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Topics: Affordable Care Act, CMS

Top 3 Reasons to Self-Disclose to the OIG

Posted by Mike Rosen on Tue, Oct 01, 2013 @ 08:32 AM

You might hesitate to self-disclose fraud and exclusions to the OIG due to the time-investment and immediate fines; however, according to the OIG the process does not take as long as you might think. 

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Topics: oig exclusion list, LEIE, civil fines and penalties, oig exclusion, OIG, OIG Special Advisory Bulletin, Affordable Care Act, CMS, Fraud and abuse, self-disclose

Survey Says: Verifying Staff Credentials is Most Challenging

Posted by Mike Rosen on Mon, Apr 01, 2013 @ 04:32 PM

Recently, the Joint Commission released a chart of the most challenging requirements for health care organizations.  Interestingly, for Behavioral health care companies, HR 01.02.05 Standard proved to be one of the more challenging compliance standards to meet. See chart.

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Topics: oig exclusion list, GSA, monthly oig exclusion monitoring, Affordable Care Act, CMS, HR standard 01.02.05

CMS/PPACA Compliance Advice- Do Monthly Exclusion List Checks

Posted by Suzanne Hagy on Mon, Mar 11, 2013 @ 01:24 PM

Using funds allocated as part of healthcare reform (Affodable Care Act), CMS (Center for Medicare & Medicaid Services) has stepped up efforts to locate and stop medicare fraud nationwide. As quoted from a recent Business Wire article, Donovan Ayres, Vice President of Regulatory Compliance at Clear Vision Information Systems, "CMS is being more aggressive than ever in making sure that all Medicare Advantage plans are in full compliance."

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Topics: oig exclusion list, Affordable Care Act, CMS

OIG Review of State Medicaid Fraud Control

Posted by Ashley Poort on Fri, Jan 11, 2013 @ 03:21 PM

The OIG recently recently its 2012 review of the Louisiana State Medicaid Fraud Control Unit.  Among other findings, the review found that 14% of sentenced providers were not referred to the OIG for exclusion within the appropriate time period ("30 days or other reasonable time period" according to Performance Standard 8(d)).  These providers were not reported to the OIG until after the review.

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Topics: oig exclusion list, civil fines and penalties, oig exclusion check, monthly oig exclusion monitoring, OIG, exclusions, Affordable Care Act, OIG Exclusion Monitoring, Medicaid, Medicare, Fraud and abuse, OIG exclusion list check, Fraud Control, Lousiana Fraud Control, OIG Review

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