2015 Fraud Licensing Medicaid 
Compliancy Group
FEBRUARY 16, 2024
This month, fraud in the medical industry has been making headlines fairly frequently. In one case, the dentist himself was involved, practicing on a revoked license. We also covered two Medicaid fraud schemes , one resulting in billions of dollars in billing for medical supplies that were never received.
MedTrainer
JANUARY 12, 2024
Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. Compliance evolved to include performance reporting and quality metrics.
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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.
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 9001:2015 (quality management).
Kaiser Health News
JANUARY 19, 2022
A spokesperson for the Centers for Medicare & Medicaid Services said in an email that the agency is not seeing a pervasive problem, but he declined to provide data on how often such cases occur or how the agents or brokers get the personal information needed to enroll unsuspecting people. States also can revoke agents’ licenses.
Provider Trust
MAY 18, 2022
In January 2015, the OIG settled for $96,259 with a Minnesota Pharmacist, Joseph C. In addition, the suit involved alleged submission of false claims for reimbursement to the Massachusetts Medicaid Agency. Moon , for submitting claims while excluded from March 2006 through July 2013. The defendants settled and paid $19.95
Hall Render
APRIL 22, 2022
Supreme Court tosses Medicaid work requirement cases. San Francisco’s Laguna Honda Hospital Loses Medicaid, Medicare Funding. Colorado Springs health clinic to pay settlement in fraud lawsuit. Iowa licensing board loses legal fight over subpoenaed patient records. Hospitals to receive a proposed 3.2% CONNECTICUT.
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