Enter your search term above.
New DOJ Opioid Fraud and Abuse Detection Unit Created
New DOJ Opioid Fraud and Abuse Detection Unit Created

Throughout the year, the Office of Inspector General (OIG), as well as the Department of Justice (DOJ) and President Trump, have made it clear that opioid abuse is a primary area of focus for government agencies. In a recent announcement, Attorney General Sessions showed that the government isn’t just talking- they are taking action. On August 2nd, Attorney General Sessions announced the formation of the Opioid Fraud and Abuse Detection Unit. This new unit of the DOJ will be a pilot program to utilize data to help combat the opioid crisis.

CMS Delays SNF Penalties for Phase 2
CMS Delays SNF Penalties for Phase 2

On June 30, the Center for Clinical Standards and Quality/Survey & Certification Group issued a memorandum outlining revisions to the State Operations Manual (SOM) Appendix PP for Phase 2, F-Tag revisions, and several other related issues specific to the Requirements of Participation of nursing centers. The new CMS mandates include the minimum health and safety standards that skilled nursing facilities must meet to participate in Medicare and Medicaid.

New Mexico Takes Aim at Medicaid Fraud and Abuse
New Mexico Takes Aim at Medicaid Fraud and Abuse

New Mexico’s Attorney General Hector Balderas takes Medicaid fraud very seriously, and late last week announced several new initiatives to weed out Medicaid fraud in his state. For the first time in New Mexico’s history, the Attorney General has requested and received a waiver from the federal government to allow the Office of the Attorney General to proactively search through data to identify patterns of fraud.

OIG Continues Focus on Skilled Nursing Facilities
OIG Continues Focus on Skilled Nursing Facilities

Like most compliance officers, I receive compliance updates in my inbox every day from various vendors, compliance organizations, and of course the Office of Inspector General and Department of Justice. I always make sure to read all of the recent government settlements but maybe because of my background and love for the post-acute sector, I continue to notice how frequently the OIG and DOJ focus on the post-acute sector, and often more specifically on skilled nursing facilities.

Quick Guide to the OIG Self-Disclosure Protocol
Quick Guide to the OIG Self-Disclosure Protocol

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.

The Complexities of Exclusion Monitoring
The Complexities of Exclusion Monitoring

Let’s take a stroll down memory lane. Do you remember when you were the new compliance officer in your organization? Maybe you were reviewing all of the compliance processes and trying to determine what was working well and where things might need a little improvement? At some point, if you’re like me, you began to review the exclusion monitoring process and quickly realized you need some help.

What’s New in Corporate Integrity Agreements from the OIG?
What’s New in Corporate Integrity Agreements from the OIG?

As we all know, Corporate Integrity Agreements (CIA’s) are an excellent resource to a compliance officer when trying to stay ahead of the ever-changing compliance landscape. CIA’s provide a wealth of information as to what the Office of Inspector General (OIG) believes should be elements of an effective compliance program. They can also help clarify roles and responsibilities of the board or senior leadership in a healthcare organization. It is highly recommended that you monitor CIAs posted on the OIG site on a periodic basis to see if the model CIA has been updated or changed.

ProviderTrust | Our Story
loading