A recent audit by the U.S. Department of Health and Human Services Office of Inspector General (OIG) has raised serious concerns about how nursing homes are screening their employees

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 hires have been excluded by the...

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. MFCUs are funded jointly by federal and state governments...

When a health care entity is faced with permissive exclusion from participation in federal health care programs, the Health and Human Services Office of Inspector General (OIG) has the discretion to offer a Corporate Integrity Agreement (CIA) in lieu of...

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 entities have been excluded. Overall, more...

What Is A Sanction Check Sanctions against medical personnel can create significant risk to a healthcare organization from financial, compliance and patient safety perspectives. Therefore, it is critical that organizations such as provider groups, health plans and health care facilities...

U.S. healthcare providers who participate in federal or state healthcare programs such as Medicare or Medicaid must be vigilant in their hiring practices. Hiring or retaining excluded individuals or entities can subject providers to significant penalties if an employee, contractor,...

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 exclusions in 2017, with Florida, California, New York...

Solution Concept Human Resource on Blackboard The Office of the Inspector General (OIG) maintains a list of those individuals and identities who are prohibited by federal law from participating in Medicare, Medicaid, and all other federal healthcare programs. How does...