Stay up to Date
Get the latest healthcare compliance news, advice from industry experts, and all things related to OIG exclusions delivered straight to your inbox.
The only thing possibly scarier than those words is – "I am from the IRS and I am here to help." Well, it doesn't have to be that way. Auditors get a bad wrap. The first image that comes to mind is the corporate cop without a personality who is just looking for that violation. But an audit is a very important part of an effective compliance program. In fact, it is one of the seven elements. The purpose of a healthcare compliance audit is four fold:1. To prove you are in compliance2. To show areas where they can be improved 3. To cement into place best practices that you have implemented and to make your organization's compliance plan even better, and 4. To be ready to pass an outside party/regulator official audit.
Exclusion Workshop If you haven't heard yet about our monthly webinars. No worries! For all who attended last month's Exclusion Data Deep Dive Workshop, it was a pleasure meeting each one of you. If you didn't get a chance to join us, you were certainly missed! We also want to take a special moment and share the actual webinar with you. And the best part is - it's free! And there were some interesting exclusion finds from this quarter's special report, CHIRP, too. We have a special on demand version of our October workshop available for you today.
Today is the day! Join us at 12:00 PM CST for our webinar titled, "Exclusion Data Deep Dive Workshop" In this workshop, we will discuss the time delay in states reporting to the OIG and the missing exclusions on the OIG list. You may know that states are not good at reporting exclusions to the OIG, but you may not know just how bad they are at reporting. Join the compliance conversation today! Reserve your seat now.
CHIRP: Q-3 Review and Lessons learned According to the recent CHIRP report The third quarter results of CHIRP found some interesting trends in healthcare compliance data. The OIG continues to impose civil fines and penalties for hiring or contracting with an excluded individual or entity. In fact, in the third quarter the fines amounted to almost $2.25 million and were imposed against 23 individuals in 12 different states.
How do you create your training plan? So as you consider what your training calendar is going to look like for 2017 take a step back and really look at your outcomes to help guide you in preparing your calendar. Of course, you have to include any State or Federal required training based on your industry. You would also include fraud, waste and abuse training, likely resident/patient rights, abuse and neglect training too. But what areas are your outcomes telling you need some extra attention this year?
New Hire! We are excited to announce ProviderTrust is expanding its services to include the new Compliance Integrity Division. Donna Thiel, healthcare compliance veteran, has joined our ranks and will lead the new division. With over 30 years of experience in the post acute care sector, including 15 with one of the nations largest long-term care providers in the industry, she is a perfect fit.
"The moment you meet a stranger, both of your brains are making thousands of computations at lightening speed to make major decision about one another," according to an article in Forbes. This only take seven seconds. It only takes seven seconds to make a first impression.
Happy 40th Anniversary, DHHS OIG! My you have certainly made an impact on healthcare compliance. This week marks the 40th anniversary of the formation of the Office of Inspector General for the Department of Health and Human Services.
In what is generally considered a standard provision, the companies' agreements allowed for the former employee's participation in any government investigation but required a waiver of the right to recover any incentive payments the law provides for whistleblowing in healthcare.
Former Chief Executive of South Carolina Hospital Pays $1 Million and Agrees to OIG Exclusion to Settle Claims Related to Illegal Payments to Referring Physicians
Time is Money “They” say that time is money. Chief Operating Officers may say training costs too much money. Compliance Officers say training saves money. In the end, training time may be costly but it will save the company from having to spend money paying fines or being sanctioned for non-compliant activities. Now, ask yourself, have you done a good job training your staff in 2016 or is your training more like the cartoon above?
Did you know . . . that there are very limited circumstances in which a person who is excluded by the OIG can still provide services without incurring a penalty? It's true. But in a very limited cases. As the OIG reported recently, a provider in a rural area, where there are no other options or access to such medical service, can still provide services and be reimbursed by federal health care dollars, IF he/she obtains a waiver from the OIG.
Cindy Daigle, Director of Compliance at U.S. Renal Care, shares her thoughts on hiring best practices. Compliance Team hiring practices plays into the long term success of the organization as well as driving the company’s compliance.
Auditing The OIG is tasked with auditing the performance of state Medicaid Fraud Control Units (MFCU). The mission of Medicaid Fraud Control Units (MFCUs or Units) is to investigate and prosecute Medicaid provider fraud and patient abuse or neglect under state law.
Whistleblower Think back to your first PE class in elementary school or your proudest moment in high school and the winning goal for that state championship game. Then, there is that dreaded whistle from the referee. Suddenly, everything stops for the man in the stripped uniform and the power to stop everything in its tracks (the whistle). What will happen? What did he/she see that commanded a stop of the game? Ok, now that I have your attention (and maybe that cloud nine moment in time), that whistle sometimes is not bad and signals a chance to check on a key play or issue. This blog will address two points on whistleblowing in healthcare: (1) How to develop a safe environment for self disclosure and (2) the impact of a whistleblower action on your organization.
Preventing Healthcare Fraud and Abuse: Did you know companies spend millions on educating staff how to avoid it, detect it and report it? Is your staff is aware of when fraud exists, are they aware of how and to whom they can safely report it internally? You better know the answer and it needs to be clear they feel safe reporting it for you to investigate and handle. Otherwise, they will be whistling while they work – but to a tune you will not like and can cost your organization millions.
A Texas skilled nursing facility settles with the OIG for $408,159.53 resolving allegations that they employed an office manager who provided items or services to the facility's patients that were billed to federal healthcare programs. Makes you think about how deep your exclusion monitoring program is and its effectiveness.
Hire the Best In today's highly regulated and litigious society, healthcare providers are expected to hire the best trained, qualified and properly licensed staff. Not just a background check, but in certain industries, a particular set of checks, including criminal, OIG exclusions and others.