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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, CMS, Self Disclosure, Sanction Screening, License Verification

More Scrutiny to Sell Weed in Colorado than to Get a Medical License

Posted by Michael Rosen, ESQ on Tue, Jul 12, 2016

Colarado high takes on a new meaning. When you compare the requirements to become a licensed medical marijuana dealer in Colorado to that of the scrutiny conducted by the Colorado Board of Nursing, you would be surprised which is harder to get. The Colorado Dept. of Revenue, Enforcement Division, will actually conduct a background check on an applicant for medical marijuana dealer, and the Colorado Nursing Board will not.

According to a recent article in the Denver Post, it is one of six states that do not require a background check in order to get a nurse license.  

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License Verification

Unlicensed Care: It's Healthcare License Fraud and a False Claim

Posted by Michael Rosen, ESQ on Tue, May 31, 2016

How important is it that a medical professional has a current, or for that matter, just a license?  Sounds like a rhetorical question doesn't it?  Well, it's also a legal question. 

In order to provide medical care, one must be trained and educated, at a minimum.  In certain cases, they must also be licensed and/or have a certification.  

Let's focus on physicians.

Each state has a Medical Board and associated regulations surrounding the requirements to obtain and maintain a medical physician's license.  In Ohio, the state law requires a medical practitioner who performs certain medical services to be licensed in Ohio.  

A recent Department of Justice case found several Ohio men to be liable for submitting false claims and for fraud when practicing medicine without a license in Ohio.  Cecil Alexander Kent, Jr., pled guilty to one count of conspiracy to commit healthcare license fraud, two counts of healthcare fraud and five counts of making false statements relating to healthcare matters. Kent admitted in court while he was employed at B&M Visiting Doctors PLC., and while he was unlicensed in Ohio, he treated patients and falsified related patient records, including medical documents. He falsified prescriptions for controlled substances he wrote using the name and U.S. Drug Enforcement Administration number of a licensed physician.  

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OIG Exclusion List, Healthcare Compliance, OIG, Medicaid, Medicare, Fraud and Abuse, Penalties and Fines, Sanction Screening, Long Term Care, License Verification

Healthcare license fraud is a reality - here's how to avoid it

Posted by Michael Rosen, ESQ on Thu, May 26, 2016

How can a company protect itself from a fraudulent employee?

For those of us who work in the healthcare industry, we all know how imperative and complicated healthcare licenses can be. Ensuring employee’s licenses are up to date and properly verified can be a headache for organizations industry-wide. Although organizations might think they are doing everything correctly and thoroughly, they could be terribly wrong. Errors in the healthcare license verification and tracking process is a very real possibility, especially in large companies that have thousands of employees and vendors. And yes, it is the company’s responsibility to verify all licenses and all other required documents.

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