It’s an event that will go down in history: the Great Oscar Debacle of 2017. Nobody could possibly forget that fateful moment when Faye Dunaway attempted to regroup from a dazed and confused Warren Beatty reaction to b...
How Nurse Fraud & Their Exclusions are Taking a Serious Toll on the Healthcare System
February 27, 2017
Nurses Most Excluded Position Type Every Year When reviewing the numbers of LEIE exclusions, it is alarming to see the dramatic difference between nursing and other medical fields: Nurses are excluded from participatin...
Understanding OFAC Administered Sanctions Programs
January 16, 2017
The Role of OFAC The U.S. Office of Foreign Asset Control (OFAC) is the department of the U.S. Treasury responsible for promoting U.S. foreign policy and national security agenda with regard to foreign powers, whether in...
Healthcare Hand-off: Obama’s Outgoing Health Cabinet vs. Trump’s New One
January 4, 2017
It’s no secret that Republicans want to replace Obamacare with another option. According to polls, 53% of Americans disapprove of ACA, and 45% have shown their approval. With the public as well as party lines divided o...
Health Compliance: A Guide for MAOs & Their FDRs
December 22, 2016
Hand Holding Magnifying Glass Seaching Missing Puzzle Pieces "COMPLIANCE" One of the ways that the Centers for Medicare and Medicare Services (CMS) ensures quality service and safety throughout their vast network of or...
Avoid Medicaid Recoupment: Verify Beneficiary Date of Death with the Death Master File
December 19, 2016
Crisis Concept. Money Flow in Black Hole extreme closeup The CMS requires State Medicaid agencies to use the Social Security Administration’s Death Master File to screen and verify all providers. It should be noted...
The NPI Registry and Why It Matters
December 12, 2016
What is an NPI Number? Provider Identifiers (NPIs) were created to ensure for accuracy and efficiency in the health care system when it comes to transmitting information that references healthcare providers electronically, with an aim to help reduce fraud and abuse. That is, with so many possible variables, a system of unique numerical identification for each provider was a clear way to streamline operations....
Highlights of the 2017 OIG Work Plan
November 23, 2016
 The OIG recently released their 2017 OIG Work Plan. It’s a great way to be informed of what new and ongoing reviews and activities the OIG considers a top priority for this coming year's agenda. Here are some ex...
NJ Provider Agrees to 20 Year OIG Exclusion On-Top of 5.25 Million Dollar Settlement
November 22, 2016
Auction Or Trial Concept With Auctioneers Or Judges Gavel And Scattered Money Heap On Wooden Table, Close Up, This week there was a stunning announcement made by the OIG regarding a New Jersey OB/GYN doctor that a...
