Nurse Fraud Nurses have become heavily involved in a spate of health-care related fraud news in recent years. One of the most controversial reports of fraud from the Department of Justice was in 2011, which involved ei...
The Fraud That Binds?

Just a few months into 2016, and already, a mother-daughter tandem is causing ripples in the health care pond by pleading guilty to second-degree Medicaid fraud in Hawaii last March 9. The “mother” in this c...
Exclusion Screening VS. Fragmented Databases

Is Exclusion Screening even possible? The U.S. Government Accountability Office has recently released the results of a study conducted in order to gauge the reliability, uniformity, and exhaustibility of exclusion databa...
Daniel Levinson’s Parthenon of Compliance

The Parthenon of Healthcare Compliance https://youtu.be/5TQg1A3ovRA At the 2016 HCCA Compliance Institute, an annual conference for compliance stakeholders, Inspector General of the U.S. Department of H...
FDNY Medicare Fraud

The Frightening Reaches of Healthcare Fraud The U.S. public healthcare system loses approximately $60 billion annually to medical fraud. This disconcerting figure, which could have gone to better use and could h...
Permissive Exclusions Updates from the OIG to 1128(b)(7)

Recently on April 18, 2016, the Inspector General of the famed OIG issued a review and updates on their exclusion policies and how they go about permissive exclusions. The OIG was established back in 1976 in order to p...
Basic Guide to OIG Reinstatement

A Quick Guide to OIG Reinstatement Excluded healthcare professionals are banned from participating in any US healthcare program, including Medicare and Medicaid. Exclusion means individuals and entities are not allowed,...
Five Exclusion Stats Every Healthcare Provider Needs To Know

Exclusion Stats Here’s a collection of five interesting stats related to the List of Excluded Individuals and Entities (LEIE). If healthcare compliance is something that affects your business, then these exclu...
How to Do Pre-employment Screening the Right Way

OIG Background Check Basics: Not every medical practice is large enough to employ a full-time compliance officer, but every medical facility is large enough to get slammed by the OIG for messing up on some part of the sc...