Medicaid and Medicare frauds run to the tune of billions of dollars each year. Running a check on OIG exclusions is one way to catch this fraud, and also protect one’s healthcare system from doing business with blacklisted entities and individuals....
The Baby-Boomer Effect: How Healthcare Fraud is Turning Grey
January 18, 2016
The National Healthcare Anti-Fraud Association approximates 3 to 10 percent of annual healthcare expenditures account to fraudulent claims. This means that in the $600 billion spent for Medicare back in 2012, $60 billion was lost to healthcare fraud. This...
2015: OIG Compliance Year in Review
January 6, 2016
How did healthcare compliance fare in 2015? Overall, it was quite a busy year for the OIG and various organizations, with noteworthy settlements and enforcement activities beginning as early as January. The OIG excluded 4,112 individuals and entities from participation...
Driving Healthcare Costs Down, By Bringing OIG Compliance Up
January 4, 2016
Why does medical care cost so much, anyway? Dumb question.  It doesn’t take a rocket scientist to understand that healthcare costs.  Treatments cost, prescriptions cost, equipment costs.  Everybody knows that. Not everybody knows that bloopers cost.  Big time. The...
The True Costs of Transitioning to ICD-10 {Infographic}
December 14, 2015
The True Costs of Transitioning to ICD-10 When it comes to streamlining, medicine often gets a bad rap. There’s lots of paperwork, referrals, appointments, and questionnaires to fill out—and that’s often before patients even get to see a doctor. But...
In the Mind of the OIG
October 21, 2015
Robert DeConti, assistant inspector general for legal affairs at OIG, and Lisa Re, chief of the OIG Administrative and Civil Remedies Branch, explain why some get excluded...and others don't. OIG enforcement actions are often cloaked in a veil of mystery....
The Most Outrageous Frauds [Infographic]
October 15, 2015
The cases presented below prove that fraud hurts real people every single time it happens. Outstanding medical bills have become a chief reason for filing personal bankruptcy in the US. The health of patients continue to deteriorate because of neglect...
Top 10 Reasons NOT to Invest in Exclusion Screening Software
October 12, 2015
Why Not to Invest in Exclusion Screening Software Plenty of healthcare organizations don't use exclusion screening software. Wondering why not?  Here's what they'll tell you! It's no big deal to do exclusion checks in-house.  Our office staff loves to re-screen every employee over multiple databases every month....
The Great Exclusion Snowball
September 21, 2015
Global warming and the Artic freeze are not our forte, but we've granted ourselves the liberty of forecasting what our 'weathermen' see coming up on the horizon: The Great Exclusion Snowball. Over two months ago, we blogged about the the OIG alert targeting...
