The Anti-Kickback Statute: A Continuing Compliance Challenge
In recent months, the spotlight in the healthcare industry has largely been focused on the Congressional debate regarding healthcare reform, including implementation of federal…
Meeting the Challenge of Medicare Appeal Delays
Two years and counting … The Web site for the Office of Medicare Hearings and Appeals (OMHA) in the U.S. Department of…
Medicaid vs. Medicare Claims Audit Appeals: A Road Less Clear
In recent years the enforcement climate has become harsher than ever before as more and more providers experience significant recovery…
Elements Of An Effective Compliance Program – Written Policies And Procedures
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) provides guidance to various healthcare providers…
Highlights Of HHS’ December Enforcement Actions
The Department of Health and Human Services (HHS) wrapped up 2013 with successful enforcement actions in its never-ending effort to…
Compliance Officer and the Audit Committee: Building an Effective Relationship
Both the compliance officer and the audit committee play important roles in a healthcare provider’s compliance program. The compliance officer administers the program…
Medicare Exclusion Database
The Centers for Medicare & Medicaid Services (CMS) has implemented a Medicare Exclusion Database (MED). It is an online application…
OIG’s Monthly Enforcement Actions Against Organizations That Hire Excluded Individuals
In October, the Department of Health and Human Services Office of Inspector General (OIG) reported on three cases where healthcare…
OIG Upgrades Online Searching Of The List Of Excluded Entities Database
On May 8, 2013, the HHS Office of Inspector General (OIG) issued the “Special Advisory Bulletin on the Effect of…
Can The Entire Sanction-Screening Process Be Outsourced?
This is a question that is frequently asked of me and the answer is yes. Vendors can not only provide…
More Home Health Fraud Cases
The month of September was a banner month for crackdown on home health care fraud cases. Almost on a daily…
Compliance Program Leveraging of Audit Resources
The compliance officer is an independent and objective fact finder with the mission of ensuring the organization is in compliance with all…