The Compliance Institute (CI), a flagship event held by Health Care Compliance Association® (HCCA), has been supporting practitioners with educational and networking opportunities for two and a half decades. This confer...
Highlights from the OIG’s Fall 2021 Semi-Annual Report to Congress
On December 2, 2021, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) issued its Semiannual Report to Congress for fiscal year 2021 (Report). The Report describes OIG’s work id...
Apache Log4j Vulnerability – What You Need to Know
Background On December 9, 2021, security researchers discovered a flaw (also referred to as a vulnerability) in the code of a software library used for logging security and performance information. The Apache software...
The Role of Delegated Entities in Exclusion Screening
Under federal law, Medicare Advantage plans and Part D plan sponsors may delegate administrative or healthcare service functions to third parties, such as a medical group, pharmacy benefit manager, claims administration ...
OIG’s 2021 Top Management & Performance Challenges Facing DHHS
Introduction The 2021 Top Management and Performance Challenges Facing HHS is an annual publication of the Department of Health and Human Services (DHHS) Office of Inspector General (OIG). The OIG has identified six t...
The Continuing Rise in Drug Compounding Fraud
When most people think about pharmaceutical fraud, they may envision pharmacy staff shorting a prescription to pocket a few pills and then overcharging the patient, or taking pharmacy inventory to sell on a shady interne...
Employers – Dig Deeper! The Role of Abuse Registries in Employee Screening
There are specific screening requirements for health care employers who receive federal funds as participants in federally-funded health care programs, but screening against abuse registries is an often-overlooked resour...
Exclusions Due to Overpayments – Cautionary Tales
While it seems unlikely that an organization’s mail management can result in exclusion from a federally funded program, many errors seem to be causing major headaches for well-intentioned, high- performing organization...
Vendor Management is a Risky Business
Screening employees and potential hires against federal and state exclusion lists can be relatively straightforward if an organization’s HR department maintains current employee data and utilizes the services offered b...