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Operation Nightingale and Protecting Your Organization from Potential Licensure Fraud

Provider Trust

Three schools across Broward County and Palm Beach County, Florida, were involved in this multimillion-dollar fake diploma scheme: Siena College of Health, Palm Beach School of Nursing, and Sacred Heart International Institute. In addition, an estimated 37 percent of student nurses with fake diplomas passed the NCLEX.

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Ineligible Medicaid Provider Arrested for Defrauding Medicaid of More Than $68K

Healthcare Compliance Blog

According to a Medicaid Fraud Control Unit investigation, the provider had failed to disclose his former felony convictions that precluded Medicaid from accepting the application. The provider had created a business to provide home and community-based services to Medicaid recipients. List of Excluded Individuals/Entities ?(LEIE).

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Pennsylvania Man Excluded from All Federal Healthcare Programs for 22 Years 

Healthcare Compliance Blog

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare.

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The Cobra Effect & Enforcing Compliance Standards

AIHC

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?

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The Cobra Effect & Enforcing Compliance Standards

AIHC

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?

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Health Provider News

Hall Render

NATIONAL 6 health systems using GPT and AI tools 100,000 nurses left industry during the pandemic, report finds AHA backs bill to delay Medicaid DSH cuts by 2 years AHA launches info hub for healthcare quality leaders AHA opposes MedPAC recommendations to Congress on site-neutral, Part B drug, wage index policies AHA ramps up 340B protection efforts (..)

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Hall Render’s Health Provider News – January 28, 2022

Hall Render

FDA halts use of antibody drugs that don’t work vs. omicron. Safety-net hospitals face the worst of the US’ nursing shortage. State health officer discusses Alabama’s COVID-19 peak. Alabama lawmakers talking about how to use next round of federal pandemic relief funds.