Medicaid Fraud Control Units: 2020 Results
Key Points: The OIG reported that MFCUs recovered more than $1 billion in Fiscal Year 2020. MFCUs evidenced a return on…
Subjects Sentenced in $150 Million Hospice Fraud Case
3 Categories of Hospice Fraud The three major categories of hospice fraud are: (1) false claims for unnecessary, improperly delivered,…
Evidencing a Culture of Compliance
Key Points: The 2020 Department of Justice (DOJ) Evaluation of Corporate Compliance Programs raises many questions related to the ability…
Chief Compliance Officer vs. General Counsel: How Should They Interact?
Major 2021 HCCA Program Topic One of the most discussed compliance issues is the contrast between the roles and authorities…
Evidencing Employee Understanding of Compliance Training
Key Points: Compliance officers are responsible for ensuring that all employees understand compliance requirements. Learning is hard, and forgetting is…
New FBI Internet Crime Report
Key Points: The report includes COVID-19 scam and state-level statistics. Tips for preventing attacks are included below. The Internet Crime…
OIG Reviews Find Improper Documentation for Telemedicine Services
Key Points: The OIG is auditing state compliance with federal and state telemedicine requirements. An audit of South Carolina’s telemedicine…
DOJ Fraud Section Issues 2020 Report
The Fraud Section of the United States Department of Justice (DOJ) issued its 2020 Year in Review report. It notes that…
HHS OIG Speaks Out on Telehealth Fraud
Christi A. Grimm, the Principal Deputy Inspector General of the Department of Health and Human Services (HHS), issued a statement regarding telehealth…
Critical Written Guidance for Effective Compliance Programs
Both the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) and Department of Justice (DOJ)…
Expedited Compliance Document Evaluation
Key Points Many seek the quickest and least expensive means to have their compliance programs evaluated. Common methods for independent…
Checklist for Addressing Ongoing Monitoring and Auditing
There remains considerable confusion among compliance officers regarding the proper management and ownership of monitoring and auditing functions. “Monitoring” is…