Nurse Fraud Nurses have become heavily involved in a spate of health-care related fraud news in recent years. One of the most controversial reports of fraud from the Department of Justice was in 2011, which involved ei...
The Fraud That Binds?
June 20, 2016
Just a few months into 2016, and already, a mother-daughter tandem is causing ripples in the health care pond by pleading guilty to second-degree Medicaid fraud in Hawaii last March 9. The “mother” in this c...
Compliance Officers and the HR Department
June 14, 2016
The Differences between Compliance Officers and the HR Department The HR department of any organization has a crucial role to play in ensuring compliance, and company compliance officers have the important res...
Texas OIG and Medicaid Exclusions
June 6, 2016
Texas OIG and Medicaid Exclusions Under the guidance of Inspector General Stuart W. Bowen, Jr., Texas OIG functions within a singular mission: " To detect, prevent, and deter fraud, waste, and abuse through the audit, in...
Exclusion Screening VS. Fragmented Databases
May 30, 2016
Is Exclusion Screening even possible? The U.S. Government Accountability Office has recently released the results of a study conducted in order to gauge the reliability, uniformity, and exhaustibility of exclusion databa...
Daniel Levinson’s Parthenon of Compliance
May 18, 2016
The Parthenon of Healthcare Compliance https://youtu.be/5TQg1A3ovRA At the 2016 HCCA Compliance Institute, an annual conference for compliance stakeholders, Inspector General of the U.S. Department of H...
FDNY Medicare Fraud
May 10, 2016
The Frightening Reaches of Healthcare Fraud The U.S. public healthcare system loses approximately $60 billion annually to medical fraud. This disconcerting figure, which could have gone to better use and could h...
Permissive Exclusions Updates from the OIG to 1128(b)(7)
May 2, 2016
Recently on April 18, 2016, the Inspector General of the famed OIG issued a review and updates on their exclusion policies and how they go about permissive exclusions. The OIG was established back in 1976 in order to p...
NY Medicaid Exclusion
April 14, 2016
New York State Medicaid Exclusion New York’s Office of the Medicaid Inspector General exists to “to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusive, and wa...
