Verisys

NOVEMBER 14, 2023

Primary source verification must be done to confirm a provider’s education, professional license and certifications, medical training, work history, references, and more. Provider information should be continuously monitored for any changes to exclusion or license status. However, verifying a provider’s credentials is essential.

Licensing 52

Licensing Medicaid Medicaid Governance 52

Pharmacy Law Blog

MARCH 13, 2018

The relator McKenzie Stepe, a former RS sales representative, originally filed her complaint in December 2013. She accused RS and Gobea of charging Tricare, Medicare and Medicaid excessively high rates for certain compounded drugs. fraud suit – judge.” The Relator’s FCA Suit. Florida compounding pharmacy must face U.S.

Fraud 52

Fraud Governance Licensing FDA 52

Verisys

JANUARY 18, 2022

Primary source verification must be done to confirm a provider’s education, professional license and certifications, medical training, work history, references, and more. Provider information should be continuously monitored for any changes to exclusion or license status. ISO 27001:2013 (information security).

Licensing 52

Licensing Medicaid Medicaid Governance 52

Healthcare Law Blog

MAY 31, 2022

For example, services that are billed to Medicaid or Medicare must comply with regulations that may not apply to services that are paid for in cash. Some healthcare services may implicate certain healthcare fraud and abuse laws, such as the Stark law or the federal Anti-Kickback Statute, as well as the equivalent versions at the state level.

FDA 90

FDA HIPAA Medicare Medicare 90

Provider Trust

MAY 18, 2022

Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. Moon , for submitting claims while excluded from March 2006 through July 2013.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

HIPAA Journal

JULY 24, 2023

The team’s roles are to investigate and audit the Department’s operations to prevent fraud, waste, and abuse within the Department, and also to audit and investigate potential crimes against the Department. Subsequent Acts of Congress increased the OIG’s regulatory authority to prevent crimes against the Department.

Fraud 52

Fraud Medicare Medicare Medicaid 52

Hall Render

JULY 22, 2022

CMS releases Medicare OPPS and ASC proposed rule. cancer, cardio lab fraud. Long Beach Memorial avoids losing Medicare funding after serious patient care lapses. Board suspends nurse’s license 17 months after arrest in stabbing incident. New York confirms 1st national polio case since 2013. CMS proposes 2.7%

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40