Compliance Officers have the purest hearts and truly want Ethics and Compliance programs to be embraced by colleagues. It is however easy to lose sight of the greater goal at times and accidentally subvert them.&nb...
When Gift Cards May Not Constitute Inducement
September 14, 2022
Insurers constantly look for ways both to attract new enrollees and to retain existing membership. The competition is stiff in many areas of the country, and there were instances historically where plans gave away ...
Highlights from the OIG’s Fall 2021 Semi-Annual Report to Congress
January 14, 2022
On December 2, 2021, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) issued its Semiannual Report to Congress for fiscal year 2021 (Report). The Report describes OIG’s work id...
Did you notice these changes to OIG’s searchable database?
December 6, 2019
Having an individual’s Social Security Number (SSN) or the entity’s Employee Identification Number (EIN) can assist in your exclusion screening efforts. A common method to resolve potential matches found on the LEIE,...
Minnesota Statute Mandates Monthly State Exclusion List Checks
August 1, 2019
Healthcare providers are now required by law to screen the Minnesota Healthcare Programs (MHCP) Exclusion List on a monthly basis. The State legislature amended certain subdivisions of the Minnesota Statutes which went i...
OIG Semiannual Report to Congress Includes Largest Health Care Fraud Case in History
December 10, 2017
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...
Medicaid Program Integrity Identified by OIG as Top Challenge
November 1, 2017
In 2016, the Health and Human Services (HHS) Office of the Inspector General (OIG) described its ten most pressing challenges across all HHS programs, including Medicaid. The challenges cover a range of issues including ...
NJ Provider Agrees to 20 Year OIG Exclusion On-Top of 5.25 Million Dollar Settlement
November 22, 2016
Auction Or Trial Concept With Auctioneers Or Judges Gavel And Scattered Money Heap On Wooden Table, Close Up, This week there was a stunning announcement made by the OIG regarding a New Jersey OB/GYN doctor that a...
Arizona Medicaid Exclusion
September 14, 2016
Arizona Exclusion The Arizona Health Care Cost Containment System (AHCCCS) Office of Inspector General takes on the task of safeguarding the state’s Medicaid Program which amounts to $9 billion. Its mission is “to up...
