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Considering Medicare Advantage as Your Next Product Line? Things to Know…

April 5, 2022

Health plans considering Medicare Advantage or Medicaid as a new line of business need to be well informed of the greatly enhanced oversight and requirements they will face compared to state regulation of commercial plan...

2021 Audit Alert: Background Checks for Nursing Home Employees

February 22, 2021

In January of 2021 Centers for Medicare and Medicaid Services (CMS) announced that they would be auditing compliance with the National Background Check Program for Long-Term Care Providers. The National Background Check ...

CMS Preclusion vs OIG Exclusion

February 8, 2021

On January 1, 2019, the Centers for Medicare & Medicaid Services (CMS) introduced a new tool for Medicare plans – the CMS Preclusion List.  A previous article posted in 2018 provides an excellent overview of t...

COVID-19 Health Care Changes that May Survive the Pandemic

January 4, 2021

The COVID-19 pandemic has changed the face of the health care industry on multiple fronts. These range from the multiple blanket 1135 temporary waivers issued by CMS that control how care for federal program beneficiarie...

Survey and Accreditation Activities in the Age of COVID-19

December 21, 2020

As the first vaccines are delivered across the US, we can begin to look forward to a post-pandemic future and resuming routine activities that have been sharply curtailed in 2020.  This includes the resumption of the fu...

Pandemic-Related Waivers by CMS and the Continued Importance of monitoring OIG Exclusion Lists

December 14, 2020

COVID 19 has resulted in a flurry of waivers by federal and state regulatory agencies related to the provision of health care for Medicare and Medicaid patients. The CMS blanket waivers (issued as “1135 waivers” unde...

Two OIG Reports Encourage More Vigilance about Providers’ Medicaid Eligibility

April 27, 2020

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Understanding OIG Exclusions

OIG Exclusions Screening Process

Exclusion FAQS

Quick OIG Exclusion Basics

Employing Excluded Individuals

Consequences to Employing an Excluded Individual

OIG Compliance Law

Laws and Publications on OIG Compliance

More Compliance Resources

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