The OIG exclusion list databases in the healthcare compliance industry need to be cross-checked and cross-referenced in order to remain compliant. This can be overwhelming at times, especially when it comes to understanding the difference between the lists. However, there are big differences between the OIG-LEIE and the GSA exclusion list, and most of the differences have to do with the power of the hammer and the ease of use of the data.
* Updated from original post on 12/17/2015 Healthcare compliance is complicated and full of regulations, guidelines, and oversight. Since federal tax dollars are used to reimburse health care providers for services, the Department of Health and Human Services (HHS) as well as the Department of Justice (DOJ) have oversight on how those dollars are spent. The purpose of this blog post is to give a basic understanding of exclusions, industry best practices, and a brief description of the federal exclusion databases.
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.
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.
Today is the day! Join us at 12:00 PM CST for our webinar titled, "Wait, States Aren't Reporting All Exclusions to the OIG?" In this webinar, we will discuss the time delay in states reporting exclusions to the OIG and the missing exclusions on the OIG list.
Data in Healthcare Data has been a buzzword around for the last couple of years now in just about every industry. Healthcare is no exception. We all know we need it, we know that it’s important and we should be tracking it. However, when it comes to healthcare the word “data” still feels a little ambiguous sometimes. Do you think it is the case because there is so much information to be aware and track when it comes to effective healthcare compliance?
The same practicality of investing in premium brands can be seen across all industries. How many of you have searched a website that aggregates hotel sites to find the "same room" at a lower cost? I admit I have. But did I actually get what I thought I was bargaining for? Nope – not even close. In fact, the room available was advertised on the web as the same as the hotel site, but for much more. Upon arrival, the “available room" was no longer available. What was available was a room with a view of the loading dock and dumpster in the back corner of the lowest floor. Sometimes lower cost is an indicator of something bigger – or lesser, depending on how you look at it.
The System for Award Management (SAM) site launched in 2012, but there has been little fanfare (or framework) about it, except for the many questions regarding how to search it. The most important question is: how do records get on or off the SAM database? What is the SAM Database? First, a quick recap of SAM and why you should search it. SAM stands for the System for Award Management. It was created as a result of the passage of the Affordable Care Act. The ACA tasked the government to create a more broad based and encompassing federal data set to assist organizations in finding companies the federal government has contract compliance issues and/or procurement contract issues with. In some cases, the company has defaulted on its contract or had contract fraud. In other cases, the contract may have been terminated due to poor performance or breach of contract.