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More than a Massachusetts Minute to Report Exclusions to the OIG

More than a Massachusetts Minute to Report Exclusions to the OIG

Massachusetts Mintue Men, famous in the Revolutionary War and always ready.  Unfortunately, the Massachusetts Medicaid Fraud Control Unit is not so speedy.

MFCU

Each Medicaid Fraud Control Unit (MCFU) has agreed to comply with certain performance standards. Performance Standard 8(f) requires MCFU’s to report to the OIG  all convictions for the purpose of exclusion from Federal health care programs within 30 days of sentencing. Late reporting of convictions to OIG delays the initiation of the program exclusion process, which may result in improper payments to providers by Medicare or other Federal health care programs or possible harm to beneficiaries.  This is so the OIG can determine if the actions taken warrant adding that person or entity to the OIG LEIE.

Here is how Massachusetts faired, according to an OIG audit of 2015:

  • The Unit did not report all convictions to OIG within required timeframes
  • The Unit did not report 21 of its 49 convictions to OIG within 30 days of sentencing as required by Federal regulations

Maybe a minute is too unfair to hold MCFU accountable, but thirty is not.

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Written by Michael Rosen, ESQ
ProviderTrust Co-Founder, mrosen@providertrust.com

Michael brings over 20 years of experience founding and leading risk mitigation businesses, receiving numerous accolades such as: Inc Magazine’s Inc 500 Award and Nashville Chamber of Commerce Small Business of the Year
Connect with Michael on Linkedin

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