Blog

The Impact of FCRA and FACTA on Exclusion Screening

August 30, 2021

Background The Fair Credit Reporting Act (FCRA) was signed into law by President Nixon in 1970 and took effect April 25, 1971. The original purpose of the FCRA was to give consumers certain rights and protections rela...

Improved LEIE Data Access Noted as an OIG Compliance Priority

August 23, 2021

As the keynote speaker at the Health Care Compliance Association (HCCA) Compliance Institute on April 21, 2021 the HHS OIG Deputy Inspector Christi Grimm reviewed the OIG’s top 10 compliance priorities for 2021 and bey...

ALERT: Data Discrepancies in GSA’s SAM.gov?

August 16, 2021

The regular screening of federal lists for individuals who are ineligible to participate in federal contracts is required of all federal healthcare contractors. The OIG and SAM lists, as they are commonly called, are the...

LEIE’s Weakest Link: State Data

August 2, 2021

Federal exclusion requirements have been in place for years. However, in the last decade there have been significant legislative efforts to strengthen and extend Medicaid program integrity controls to protect beneficiari...

Utah MFCU Performance Overview

July 26, 2021

Background The function of Medicaid Fraud Control Units (MFCUs/Units) is to investigate and prosecute Medicaid provider fraud and patient abuse/neglect. The Social Security Act requires each state to operate a MFCU. M...

Fraud Fallout from the Pandemic

July 19, 2021

Without question, the COVID-19 pandemic profoundly affected the health care industry. In some cases, the effects were fleeting, such as hospital over-crowding and supply chain challenges related to masks, oxygen and vent...

Texas OIG Quarterly Report Highlights: Texas Continues to Pursue COVID-19 Related Fraud

July 12, 2021

The COVID-19 pandemic drove significant changes and expansion in care delivery practices. The federal government and the State of Texas implemented policy and treatment flexibility to ensure continued access to care and ...

CORPORATE INTEGRITY AGREEMENTS – AN OFFRAMP ON THE ROAD TO EXCLUSION

July 5, 2021

When a health care entity is faced with permissive exclusion from participation in federal health care programs, the Health and Human Services Office of Inspector General (OIG) has the discretion to offer a Corporate Int...

FEDERAL COVID-19 FRAUD CRACKDOWN – FULL SPEED AHEAD IN 2021

June 28, 2021

Beginning in 2021, both the HHS OIG and the DOJ have leveraged their resources to focus to the fraud and abuse schemes against federal health care recipients and programs related to the COVID-19 pandemic. As the pandemic...

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