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The ProviderTrust Blog

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

Data Management, Compliance Plan, Compliance Data, Compliance Dashboard

The Importance of a Compliance Dashboard

Posted by Donna Thiel on Thu, May 18, 2017

Compliance moves fast these days, with all of us wanting information at our fingertips. As a former Chief Compliance Officer of a very large post-acute care company, I know how much data is available and how difficult it can be to turn that data into something useful or meaningful.

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OIG Exclusion List, Healthcare Compliance, OIG, Healthcare Technology, Vendor Compliance, Data Management

Vendor Compliance Goes Beyond Employee Monitoring (Beyond Employee Monitoring eBook)

Posted by Michael Rosen, ESQ on Thu, Mar 02, 2017

Our latest eBook, Beyond Employee Monitoring: Vendors, Contractors and Third Parties, dives into the complexities of vendor monitoring. From digesting new regulations to discussing best practices, we hope this book helps you tackle your job with confidence. 

Download our free Beyond Employee Monitoring eBook here to kick start your vendor monitoring process.

Our eBook journey began with the release of The Ultimate Guide to Exclusion Monitoring. It covers everything you need to know about Office of Inspector General (OIG) exclusion monitoring and the OIG's regulations surrounding monthly monitoring and exclusion databases. We received an overwhelming amount of positive feedback for our exclusions eBook, so we decided to tackle the ins and outs of vendor monitoring as well. This 40+ page read covers the details and risks of not complying with OIG regulations as it pertains to vendor monitoring.

We're happy to announce an addition to our eBook collection! Our newest eBook, Beyond Employee Monitoring: Vendors, Contractors and Third Parties,  dives into the complexities of vendor monitoring. From digesting new regulations to discussing best practices, we hope this book helps you tackle your job with confidence. 

Download our free Beyond Employee Monitoring eBook here to kick start your vendor monitoring process.

Our eBook journey began with the release of The Ultimate Guide to Exclusion Monitoring. It covers everything you need to know about Office of Inspector General (OIG) exclusion monitoring and  regulations surrounding monthly monitoring and exclusion databases. We received an overwhelming amount of positive feedback for our exclusions eBook, so we decided to tackle the ins and outs of vendor monitoring as well. This 40+ page eBook covers the details and risks of not complying with OIG guidance and State and Federal regulations as it pertains to vendor monitoring.

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Healthcare Technology, Fraud and Abuse, Data Management, Compliance Data

Healthcare security - a top target for cyberattacks

Posted by David Share on Thu, Sep 01, 2016

Lack of Cybersecurity

Due to the success of previous attacks and the relative lack of sufficient cybersecurity, healthcare is now the most attacked industry by hackers, fraudsters, phishers and ransomware attackers.  The problem is the healthcare industry is highly focused at what it does best, providing the best quality healthcare possible. Many of its C-level executives lean towards the healthcare side as well, however only a handful of personnel are tasked with securing the data of the entire company and its patients. Put simply, healthcare data security is not the wheelhouse of the industry. And it shows.

 

"The industry that is supposed to offer everyone reprieve and look after their well being is under attack from cybercriminals."

 

IBM, one of the technology industry's most trusted and longest running companies, has recently released a report which claims that over 100 million healthcare records were breached in 2015. These records were harvested from 8,000 devices located in more than 100 countries. In the USA, and other countries which have implemented and enforced a health data security policy, such breaches can have hefty financial repercussions. Breaches of America’s HIPAA and HITECH acts carry a minimum of $500 per piece of data that was plucked by the fraudsters. Each of the 100 million plus healthcare records can contain numerous pieces of data, which when extrapolated represents billions of dollars in fines.

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OIG Exclusion List, Healthcare Compliance, Healthcare Technology, Data Management, Human Resources, Long Term Care, Security

The compliance risks of a low-cost exclusion monitoring vendor

Posted by Michael Rosen, ESQ on Thu, Jun 30, 2016

Everyone loves to save money, but there is a time and a place when it comes to choosing a lower cost product and there is a time and a place when it comes to choosing a higher cost option. A great example of this situation is when it comes to buying new tires. As tempting as it might be to buy the cheaper brand, everyone knows investing in the premium brand of tires saves you money in the long run. Cheap tires can cause unnecessary wear on your car, whereas a set of premium tires are beneficial to numerous areas of your car like the brakes, the suspension and safety. There are certain situations when it is necessary to spend more money on a product to save yourself money in the long run. 

The same practicality of investing in premium brands can be seen across all industries.  

How many of you have searched a website that aggregates hotel sites to find the "same room" at a lower cost? I admit I have. But did I actually get what I thought I was bargaining for?  Nope – not even close. In fact, the room available was advertised on the web as the same as the hotel site, but for much more. Upon arrival, the “available room" was no longer available. What was available was a room with a view of the loading dock and dumpster in the back corner of the lowest floor.

Sometimes lower cost is an indicator of something bigger  or lesser, depending on how you look at it. 

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OIG Exclusion List, Healthcare Compliance, OIG, Medicaid, Healthcare Technology, Medicare, Data Management

Three Things to Know about NPI in Healthcare

Posted by Michael Rosen, ESQ on Tue, Jun 28, 2016

A National Provider Identification number (NPI) is unique to healthcare.  An NPI in healthcare is an identification number issued by the National Provider System (NPS) based on information entered into the NPS by one or more organizations known as "enumerators." The NPI number is unique to each person or entity applying for such number.  It is created to improve the efficiency and effectiveness of electronic transmission of health information.  

Covered entities under HIPPA must use NPI's to identity health care providers in HIPPA standard transactions. The NPI number is required to submit claims or conduct other transactions specified by HIPPA. By definition, a health care provider" is an individual, group or organization that provides medical or other health service or supplies."  This would include physicians an other practitioners, physician/practitioner groups, institutions such as hospitals, laboratories and nursing homes, health maintenance organizations and suppliers such as pharmacies and DME companies. However, it does not include health industry workers such as admissions and billing personnel, housekeeping staff, orderlies and those who support the provision of health care, but do not provide health care services.  

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