Of all the penalties issued this year by the OIG in response to healthcare organizations that employed excluded individuals, all but three were the result of self-disclosures. Which kind of makes you wonder: Why? Why would a healthcare organization go...
Is Your Partner Excluded? Doctors, Take Note.
July 13, 2015
 An attorney with HHS’ Office of Inspector General said Thursday that the OIG is hiring additional lawyers to look into taking more administrative actions against doctors. They're looking for the types of questionable payment arrangements addressed in an OIG...
What To Do if You Currently Employ an Excluded Individual
July 8, 2015
I Found Out I Employed An Excluded Party...Now What? (Understanding Self-Disclosure Protocol) Discovering that you’ve employed an excluded individual can happen even to the most meticulous in the health care industry. How you address it is...
Texas OIG Trumps All Others in Issuing Fines for Employment of Excluded Individuals
July 6, 2015
Is the Texas OIG more aggressive than other states? More efficient? More serious? Maybe all of the above. Although all state OIGs have an equal mandate to discover and prosecute medical facilities who have employed or partnered with excluded individuals...
On the Ohio State Medicaid Fraud
June 22, 2015
Since the Affordable Care Act was passed in 2010, there has been a pronounced crackdown on health care-related fraud. Why, then, have revoked/terminated providers managed to slip through the cracks and are still taking advantage of Federal health care programs?...
Whose Job is Exclusion Screening?
June 5, 2015
Is it the Compliance Department’s or HR? Many healthcare companies find this particular issue a source of confusion, which often results in astronomical penalties. Exclusion screening requires a specific policy and procedure that must be strictly implemented at all times....
How to Protect Yourself From Third Party Vendors
May 29, 2015
Healthcare companies can have a strong exclusion screening program and have it strictly implemented by their Human Resources and Compliance Departments. However, the problem can very well lie with third-party vendors. Aside from employees and staff members, vendors play a...
A Synopsis of 2014 Exclusion Fines
May 14, 2015
Here is a helpful infographic detailing the 2014 OIG Exclusion Fines. Using charts and maps, the infographic is divided into sections by type, by month, and by state. A quick look reveals 15 types of health care facilities/programs, with the...
Feds Pressuring States to Step Up Exclusion Reporting
May 7, 2015
When the Federal OIG threatens to enforce exclusion, they mean business. Pronto. The Federal OIG's Ohio State Medicaid Fraud Control Unit: 2014 Onsite Review slaps the Ohio State Unit on the grounds that it 'did not consistently submit reports of...
