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Learn how to navigate and eliminate the increase risk your organization is exposed to now with the new PPACA laws and CMS rules.
"As of January 1, 2011, the Employer must conduct a search of each and all State Medicaid Action(s) to determine if a licensee has been excluded or terminated from a Medicaid program…A thorough license and sanction searches should be performed to cover all states and federal exclusions, on a routine basis. Routine is defined as no less than once a month. Best practice is to conduct ongoing monitoring. This is a drastic change in Liability of Healthcare Organizations and required screening and monitoring."
"The Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “PPACA”), contains numerous provisions related to health care fraud and abuse and program integrity. The ACA went into effect January 1, 2011. The CMS Final Guidelines and Rules take effect March 25, 2011. The fraud and abuse provisions will have a significant impact on the compliance programs of health care organizations."
"Ongoing monitoring, looking at the status of a provider’s credentials on a defined schedule (e.g. monthly) is a best practice. Ongoing monitoring should look at, where applicable, DEA, license and sanction status at the highest possible frequency based on data update schedules at the State and Federal level. Since many agencies may report the same event over time, the first indicia of trouble would generally be caught in an ongoing monitoring program allowing the subscriber to act proactively when an adverse event surfaces."