Each year, the Department of Health and Human Services and OIG is tasked with updating Congress on its performance, trends, and actions taken to combat healthcare fraud and abuse. The mid-term report was issued for the period of October 2016 to March 2017 and describes OIG’s work on identifying significant problems, abuses, deficiencies, remedies, and investigative outcomes relating to the administration of HHS programs and operations that were disclosed during the reporting period.Read More
We are pleased to welcome a guest today on the blog - Harold Malkin, a former Assistant U.S. Attorney who specialized in the resolution of civil healthcare fraud cases involving individual providers, medical practices and institutional providers in the Western District of Washington in Seattle for over 15 years. In this article, Harold will highlight some important information regarding the permissive and mandatory exclusion authority of the Office of Inspector General (OIG) as well as some things to consider if you find yourself in settlement discussions with OIG.Read More
You found an excluded employee in your organization, now what? Likely, your first thought is a bit of panic and a lot of questions. How long has this person worked for us? How did we miss this? What position did they hold? Did we receive federal funds for the job this person held? What do I do now? If there is any good news in this scenario, perhaps it is that the Office of Inspector General (OIG) has given providers direction on how to prepare for a self-disclosure to the OIG via the OIG’s Provider Self-Disclosure Protocol (SDP) document.Read More
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.Read More
* Updated from original post on 12/17/2015
Healthcare compliance is complicated and full of regulations, guidelines, and oversight. Since federal tax dollars are used to reimburse health care providers for services, the Department of Health and Human Services (HHS) as well as the Department of Justice (DOJ) have oversight on how those dollars are spent. The purpose of this blog post is to give a basic understanding of exclusions, industry best practices, and a brief description of the federal exclusion databases.
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