Medical transportation companies have been on federal and state regulatory radar for decades, for program integrity concerns such as fraudulent billing practices and patient safety concerns. Currently there are 812 names...
Note to Florida Scammers: Exclusion Status Matters to Prosecutors

In April of 2021, defendants Stephanie Fleming and Helen Storey were convicted of multiple counts of health care fraud in federal district court in Florida. The defendants were found guilty of conspiracy to commit health...
OFAC AND ITS IMPACT ON THE TALIBAN

With recent events in Afghanistan, the role of the Treasury Department’s Office of Foreign Assets Control (OFAC) in controlling the release of funds held in US financial institutions by foreign countries or terrorist o...
The Impact of FCRA and FACTA on Exclusion Screening

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

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?

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

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

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

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...