Provider Cost Report Audits
A High Risk Area Not To Be Overlooked One high risk area often overlooked by compliance officers involves the cost…
Compliance Programs Are Not Cost Centers
Effective Programs Can Lower Costs, Increase Productivity & Improve Patient Care The DOJ, OIG, United States Sentencing Commission, and new…
OIG Special Assistant U.S. Attorneys
Don’t Be Surprised To Find an OIG Agent or Attorney as a Prosecutor The HHS OIG issued its Semi-Annual Report…
Board Oversight of Compliance
The Need for Independent Evaluations of Program Effectiveness Effective compliance programs require top-down commitment beginning at the Board. The OIG…
Home Health Care Fraud is Still Rampant
Record $400 Million Fraud Case in Dallas Home health remains the most fraud prone program for Medicaid and ranks high…
Health Care Cybersecurity is in “Critical Condition”
The Health Care Industry Cybersecurity Task Force issued a report to Congress that addresses the current state of cybersecurity in the U.S.…
Choosing Your Hotline Vendor
An Informational Guide for Hotline Vendor Selection and Tips on What to Expect from Your Vendor By definition, all effective…
Largest EMTALA Settlement
Tips for Performing Ongoing Monitoring and Auditing AnMed Health, a hospital located in South Carolina, recently agreed to pay $1.3…
Compliance Program Gap Analysis vs. Effectiveness Evaluation
Comparisons, Cost Benefits, and Considerations As compliance officers and organizations try to determine when and under what circumstances to have…
Congressional Hearing on HHS Cybersecurity
PHI Security Emphasized Congressman Tim Murphy chaired a recent hearing on the HHS cybersecurity role. The hearing included a review…
HHS Final Rule on Medicare Appeals Process
Earlier this year, HHS issued a final rule that streamlines the Medicare administrative appeal processes to address the continuing increase…
OIG Reports Medicare Paid $730 Million in Improper EHR Payments
12 percent of the $6 billion in EHR incentive payments were improper The HITECH Act established the electronic health record…