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

Time Delays in Healthcare License Reporting to State Licensing Boards 

Posted by Michael Rosen, ESQ on Thu, May 19, 2016

This blog elaborates on the time delays in the reporting of disciplinary actions to state licensing boards and how those delays impact monthly monitoring of licenses for healthcare organizations.

The differences in reporting between the states:

Just like the reporting delay between the state Medicaid exclusion lists and the OIG, there can be delays in reporting disciplinary actions to the individual licensing boards. This happens for many reasons. The main reason for this delay is due to the inconsistency in how and when the states release and publish the minutes of the disciplinary actions by the board.

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Healthcare Compliance, Sanction Screening

Three common nuances in the healthcare license verification process

Posted by Erin Lewis on Tue, May 17, 2016

Note: This is the second blog in our three-part license verification series. Read the first one below:
Generally, the process of verifying licenses is pretty simple. However, there tend to be numerous nuances and quirks between each state’s licensing boards. Learning the quirks of your state’s license board is imperative to the compliance health of an organization.

We spoke with our client success leader, Stacy Taylor, to develop a list of common nuances she found while searching in the license databases. The following nuances listed serve the purpose of articulating a general idea. Remember, these quirks vary from state to state. 

1. What if I can’t find a specific license?

As we mentioned in a previous blog, the state licensing board is deemed the “Primary Source” to verify and monitor for license renewal, license standing, and in some cases, disciplinary actions taken against the individual and/or the license. There are more than 80 different types of professional healthcare licenses - ranging from a Medical Assistant to a Board Certified Brain Surgeon - and there are 50 states with license boards and some boards have a different license database for each type of license. Considering the 50 different states and numerous types of licenses, there are thousands of possible Primary Sources that may need to be cross-referenced to verify one, single license. The main problem in verifying licenses is simply the chore of finding the license.

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Healthcare Compliance, Sanction Screening

Primary Source License Verification: Where, What & When

Posted by Michael Rosen, ESQ on Thu, May 12, 2016

A healthcare license is a privilege and not a right. By that we mean one must earn a professional healthcare license. The individual must graduate from an accredited school/program and then pass a competency exam. Such exams are administered by and regulated by a State Licensing Board or a certifying board, recognized by the state. Upon successful completion, a license is granted to such individual. Thereafter, there are obligations and requirements in order to stay in good standing with the issuing Licensing Board.  

The State Licensing Board is considered a primary source ("Primary Source") and will be the single place to verify and monitor for renewal, standing and in some cases, disciplinary actions taken against the individual and/or his/her license. In order to conduct effective compliance monitoring of licenses, a monthly monitoring of the license is critical. 

Why Monthly?

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