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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 Exclusion List, Healthcare Compliance, OIG, Affordable Care Act, CMS

NOTICE: OIG Background Check Requires OIG Exclusion Monthly Monitoring

Posted by Mike Rosen on Thu, Jul 09, 2015

The proper way to screen a healthcare employee or third party vendor includes an initial OIG background check of the List of Excluded Individuals and Entities (LEIE). This should be done prior to the hiring of or commencement of billing for the services or items purchased from a third party vendor.

The question is how often should a healthcare organization check the exclusion list after hire or contracting with a third party.

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Industry News, Healthcare Compliance, Affordable Care Act, CMS, Medicaid, Medicare, Fraud and Abuse, Penalties and Fines

New U.S. Attorney General Not Afraid to Take Down Healthcare Fraud-sters

Posted by Mike Rosen on Tue, Jun 30, 2015

Newly appointed Loretta Lynch came out of the box swinging. The HHS OIG and the US Attorney General announced a nationwide "sweep" led by the Medicare Fraud Strike Force in 17 districts. The charges were filed against 243 individuals, which included 48 doctors, nurses and other licensed medical professionals. The crackdown of health care fraud and abuse represents the largest coordinated take-down in healthcare history, both in terms of the number of defendants charged and loss amount. 

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Industry News, Affordable Care Act, CMS, Fraud and Abuse

Part 2: Major Healthcare Fraud And Abuse Concerning Miami and Detroit

Posted by Mike Rosen on Tue, Feb 17, 2015

Yes, it's a new year.  And yet, here we are again with a follow-up about the previously stated temporary moratoria on enrollment of new ambulance suppliers and home health agencies, which affects locations within the designated metropolitan areas (Florida, Illinois, Michigan, Texas, Pennsylvania and New Jersey).

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Industry News, Affordable Care Act

The New Sunshine Act Database And Why It Matters To You

Posted by Alice Martin, Compliance Consultant & Former U.S Attorney on Tue, Oct 14, 2014

The sun shined on September 30, 2014 no matter where you were!

That’s right; CMS has released the long awaited Sunshine Act database, reportable under the Physician Payment Sunshine Act, PPSA, publicly, for the first time at the end of September.  Undoubtedly, this is going to be a must read for some people, raise questions from physicians, and lead to questions about whether hospital conflict-of-interest policies are being met with complete self-disclosures by physicians.

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OIG, Affordable Care Act, Fraud and Abuse, Penalties and Fines

Major Healthcare Fraud And Abuse Concerning Miami and Detroit

Posted by Mike Rosen on Thu, Oct 09, 2014

A few months ago we blogged about a new OIG enforcement stick stemming from the authority given to them from the Affordable Care Act Section 6401.

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