The Basics - Failure to Monitor Federal Exclusion Lists Can Hit Your Bottom Line Health care providers which serve Medicare and Medicaid enrollees have a duty to know if their employees, contractors or potential hire...

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...

Every year, hundreds of health care providers and entities receive notification from the HHS OIG that they are being considered for exclusion from participation in federal programs. To date in 2021, 684 individuals and e...

Mission and Structure: The mission of New York’s Office of the Medicaid Inspector General (OMIG) is to “to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusi...

EXCLUSION LISTS DEMYSTIFIED Federal and state exclusion lists abound. There are two primary federal lists, which are addressed in this article, but to there are many other lists that should be considered when screenin...

Nurses and other health care providers must meet certain ethical standards in order to maintain their licenses. For example, in California, Welfare and Institutions Code §14043.6 and 14123, mandate that the Department o...

The vast majority of health care providers are required to have a National Provider Identifier (NPI) – a unique identifying number. The NPI registry – also known as the NPI doctor lookup or NPI CMS lookup – has bec...

In 2017, the HHS Office of the Inspector General (OIG) remained active in detecting Medicare and Medicaid provider violations, resulting in fines or settlements and exclusions from participation. There were over 3,100 ex...

The HHS Office of the Inspector General (OIG) had a busy and fruitful six months from April to September of 2017, according to the Fall 2017 OIG semiannual report to Congress. The Health and Human Services (HHS) watchdog...