Medicare Exclusion Database
The Centers for Medicare & Medicaid Services (CMS) has implemented a Medicare Exclusion Database (MED). It is an online application…
OIG’s Monthly Enforcement Actions Against Organizations That Hire Excluded Individuals
In October, the Department of Health and Human Services Office of Inspector General (OIG) reported on three cases where healthcare…
OIG Upgrades Online Searching Of The List Of Excluded Entities Database
On May 8, 2013, the HHS Office of Inspector General (OIG) issued the “Special Advisory Bulletin on the Effect of…
Can The Entire Sanction-Screening Process Be Outsourced?
This is a question that is frequently asked of me and the answer is yes. Vendors can not only provide…
More Home Health Fraud Cases
The month of September was a banner month for crackdown on home health care fraud cases. Almost on a daily…
Compliance Program Leveraging of Audit Resources
The compliance officer is an independent and objective fact finder with the mission of ensuring the organization is in compliance with all…
What Nursing Facilities Can Do to Implement a Compliance Program
Many nursing facilities have yet to develop and implement an effective compliance program, despite the fact that the Department of…
Office of Inspector General’s Sanctions And Exclusions of Healthcare Parties
During my term as Inspector General at the Department of Health and Human Services (HHS), I instituted what is now…
New Problems With GSA Debarment System
The General Services Administration (GSA) sanction screening database continues to have problems for users. The GSA debarment list, previously known…
Medicaid Sanction Screening
“To obtain/maintain active enrollment status, providers may not employ or contract with individuals/entities excluded from participation in any federal health…
Challenging Overpayment Extrapolations: Statistical Considerations
The government has recovered a record-breaking $10.7 billion in recoveries of health care fraud in the last three years, and contractor reform…
A Dozen Reasons to Not Like the GSA Debarment List
I don’t like the General Services Administration (GSA) debarment list. It provides mostly useless information with very little return on…