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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, Fraud and Abuse, mfcu, OIG Exclusion

The Path of an OIG Exclusion

Posted by Michael Rosen, ESQ on Thu, Jun 15, 2017

Maybe the Wizard of Oz had good advice: follow the yellow brick road. It may have curves and present different paths, and you may meet some interesting people along the way, but in the end, it can take you to the big castle. In this case, the castle is the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) - the ultimate enforcer for healthcare fraud. The OIG has enforcement powers with the wave of its wand. Those powers include the statutory authority to impose civil fines and penalties (CMP) and exclusions against individuals and/or entities that stray from the yellow brick road.

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Industry News, Healthcare Compliance, Fraud and Abuse

Health Care Fraud a High Priority for the DOJ

Posted by Michael Rosen, ESQ on Tue, Jun 06, 2017

This year’s American Bar Association’s 27th Annual Institute on Health Care Fraud featured Acting Assistant Attorney General Kenneth Blanco, of the Criminal Division of the Department of Justice (DOJ). Mr. Blanco reiterated Attorney General Jeff Sessions’ commitment to ferreting and fighting fraud and abuse.

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Medicare, Fraud and Abuse, OIG Exclusion

When a Five Year Exclusion Became Fifteen

Posted by Michael Rosen, ESQ on Tue, May 30, 2017

What’s the expression - if at first you don’t succeed, try, try, and try again? One way to continue to be on the OIG list of bad actors is to get caught, become excluded, and continue to bill Medicare.

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OIG, Medicaid, Fraud and Abuse

Mother and Son Conspire to Defraud Medicaid

Posted by Michael Rosen, ESQ on Thu, May 25, 2017

Does it matter whose license is used to bill CMS for services? Don’t ask these moms - they don’t know best!

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OIG, Fraud and Abuse, corporate integrity agreements, compliance program

Corporate Integrity Agreements are Not a Right

Posted by Michael Rosen, ESQ on Tue, Apr 25, 2017

There are many misunderstandings in the compliance world on how CIAs are used and whether or not the OIG is obligated to enter into one. The OIG does not have to enter into a Corporate Integrity Agreement, nor does a provider have an automatic right to one.

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