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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.
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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.
Double the Trouble It's official. Effective August 1, 2016, penalties for violating False Claims Act (FCA) have doubled. The DOJ published an Interim Rule annoucing their intent to increase the minimum per claim penalty from $5,500 to $10,781 and increase the maximum per claim penalty from $11,000 to $21,563, plus three times the amount of damages that the federal government sustains because of the false claim. The last time these fines had been raised was 1999.
Lack of Cybersecurity Due to the success of previous attacks and the relative lack of sufficient cybersecurity, healthcare is now the most attacked industry by hackers, fraudsters, phishers and ransomware attackers. The problem is the healthcare industry is highly focused at what it does best, providing the best quality healthcare possible. Many of its C-level executives lean towards the healthcare side as well, however only a handful of personnel are tasked with securing the data of the entire company and its patients. Put simply, healthcare data security is not the wheelhouse of the industry. And it shows. "The industry that is supposed to offer everyone reprieve and look after their well being is under attack from cybercriminals." IBM, one of the technology industry's most trusted and longest running companies, has recently released a report which claims that over 100 million healthcare records were breached in 2015. These records were harvested from 8,000 devices located in more than 100 countries. In the USA, and other countries which have implemented and enforced a health data security policy, such breaches can have hefty financial repercussions. Breaches of America’s HIPAA and HITECH acts carry a minimum of $500 per piece of data that was plucked by the fraudsters. Each of the 100 million plus healthcare records can contain numerous pieces of data, which when extrapolated represents billions of dollars in fines.
Hire Right! Hiring the right kind of individuals for any organization is essential! Surprisingly, they can make or break a company. That is why a lot of companies are going to great heights to ensure they are gathering and retaining the right kind of people for their organizations. Since we have been on the topic of resources lately we wanted to share a couple key tools to hiring successful people that we have found useful and want to share!
Healthcare Compliance Resources The great thing about healthcare is that there are a plethora of resources for us! We are not expected to know everything in compliance. There are plenty of people who are willing to help and want to be industry thought leaders! Plus, they are willing to help for free too! Sometimes, it is […]
MCFU Not Reporting The Virginia Medicaid Fraud Control Unit (MFCU) recovered $34 for each $1 spent on fighting healthcare fraud. However, with those stellar results, the MFCU did not report half of all convictions to OIG within required timeframes. The Unit did not report 42 of its 79 convictions to OIG within 30 days of sentencing, as required by Federal regulations.
No, not THAT TV lawyer who is constantly hogging the night time airwaves- a healthcare lawyer. As a recovering lawyer myself (still keep my license, but love using it to help me help others stay compliant), I know that I am a big believer as well as follower of certain key healthcare Attorneys and Law firms that specialize in healthcare law. Best part is, that these Attorneys provide updates and trends FOR FREE. Shocking, right?! No billable hours to learn about a new topic or insight into a new compliance topic or case. Attorneys study the law and actually like to help people understand its impact on their business or risk. News Flash: Its Ok, there are smarter people out there- and they want to help:
Do you have the right resources? What is your crisis healthcare plan? As a part of our networking series, these are all important questions that we are asking ourselves and addressing today during the webinar. To give you a sneak peak, here is a little teaser to today's topics. We hope you can join us at 12pm cst! ----------------------------------------------------------------------------------------------------------------------------- What is networking? Cultivating people who can be helpful to one professionally. "It’s not who you know. It’s who knows you, And what they know!"
Be Creative. We are all taught at an early age to be creative. It is what makes humans unique. Chart your own path. Be your own Boss. You can do anything you put your heart into. Well, sometimes we miss the opportunities that are right in front of us. Namely, your competitor.... What? Yes, that's right. The importance of building a healthcare network doesn't have to be lonely. Nor does it have to be devisive or secretive. In fact, as we recently learned from Aileen in blog 1 of our networking series, to broaden your network is valuable and it helps you realize you are not the only one struggling with the issues.
I often quote a former co-worker who says networking isn’t about who you know, it’s about who knows you. It’s also about what they know about you and about your company. And that is never more true when you are in crisis and need to rely on your network to listen to you tell your story or help you tell it. That’s why it’s so important to build open, honest relationships with key constituents when business is calm. And, to have solid positive messages about your organization as part of your ongoing communications. It’s always beneficial to have a strong supply of deposits in the goodwill bank.