Provider Trust

JUNE 1, 2022

Organizations across the healthcare continuum have experienced several workforce trends that are creating gaps in license monitoring and verifications. In this post, we’ll explore three current challenges impacting the healthcare license and credential verification process. See our Telehealth Credentialing Guide for more information.

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The Health Law Firm Blog

AUGUST 22, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

JULY 17, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

AUGUST 8, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

JUNE 26, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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Verisys

DECEMBER 8, 2022

A professional career can take a provider across state lines, and through an evolution of various license types. In order to see the full picture of an individual, the comprehensive whole of each state licensing board across all license types must be searched. Take the process back another step.

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Provider Trust

MARCH 13, 2023

State licensing boards nationwide have annulled the licenses of dozens of nurses who obtained fake degrees and used them to gain or secure employment. In Delaware, 26 nursing licenses were revoked when the nurses’ credentials were tied to the scheme. ProviderTrust recommends conducting license verification monthly.

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The Health Law Firm Blog

JANUARY 2, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On October 18, 2023, an ex-Navy officer was sentenced to 30 months in prison after he pleaded guilty to conspiracy to commit wire fraud for his role in an [.] Indest III, J.D.,

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Verisys

APRIL 2, 2024

Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Million Medicare Fraud Scheme ( Full Story ) New York-Presbyterian/Brooklyn Methodist Hospital Settles Health Care Fraud Claims for $17.3 Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Secure your success by choosing Verisys.

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Verisys

MARCH 8, 2024

Million Medicare and Medicaid Fraud Full Story Pharmacist Fraud Pharmacy Owner and Operations Manager Convicted of $2.3M With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network.

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Verisys

FEBRUARY 9, 2024

Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

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Verisys

JANUARY 2, 2024

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Secure your success by choosing Verisys.

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Provider Trust

JANUARY 26, 2022

It’s no secret–when fraud enters healthcare, things get risky. But how exactly does the HHS-OIG (Office of Inspector General), the main body responsible for conducting investigations into suspected fraudulent activity, address healthcare fraud and assess future risk of these bad actors?

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Provider Trust

JANUARY 18, 2023

In October 2022, the South Carolina Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old South Carolina woman named Alyssa Beth Steele for working as a registered nurse despite not having a license. Pursuant to federal regulations, the SCMFCU is authorized to investigate and prosecute any acts of Medicaid provider fraud.

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Verisys

FEBRUARY 8, 2024

Here’s how Verisys can support pharmaceutical manufacturers in this critical area: Comprehensive Background Screening and Credentialing: Verisys’ FACIS (Fraud and Abuse Control Information System) is a key tool for screening and continuous monitoring of healthcare providers.

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MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. But what exactly is considered fraud, waste, and abuse? These complaints can trigger an audit. Data Analysis and Trends.

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MedTrainer

FEBRUARY 5, 2024

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. The information confirms a provider is currently licensed to practice medicine.

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MedTrainer

JANUARY 12, 2024

In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. Department of Health and Human Services focuses on preventing fraud, abuse, and waste in federal healthcare programs.

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MedTrainer

FEBRUARY 12, 2024

In this blog, we’ll outline why reporting healthcare non-compliance is non-negotiable and how software platforms make it easier to stay in compliance with the myriad regulations that govern good healthcare. Non-compliance can lead to significant fines, legal battles, and the loss of license or accreditation.

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Verisys

NOVEMBER 8, 2023

The NPI does not replace other identification numbers such as a provider’s taxpayer identification number (TIN), Drug Enforcement Administration registration, license number, or Social Security number. Tracking actions to a standardized identifier provides transparency that can identify and impede fraud.

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Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.

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Licensing Fraud Compliance Nurses 52

Hall Render

FEBRUARY 8, 2023

Department of Justice (“DOJ”) charged over two dozen individuals with wire fraud and conspiracy to commit wire fraud in connection with leading the alleged fraudulent scheme – each defendant faces up to 20 years in prison. Hall Render blog posts and articles are intended for informational purposes only.

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Healthcare Compliance Blog

MARCH 10, 2022

Complaints of resident abuse in a Michigan nursing home led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursing home while her license was suspended, which is a felony.

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Hall Render

OCTOBER 20, 2023

The application must include the following: A cover letter identifying the facility or institution, address, county and number and type of beds licensed by the Connecticut Department of Public Health. The CHOW Law creates new change of ownership requirements for health care providers.

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The Health Law Firm Blog

MARCH 26, 2024

It provides information and statistics on actions involving licensed health professionals through March 2021. Indest III, J.D., Board Certified by The Florida Bar in Health Law The Florida Department of Health's Quarterly Performance Report (QPR) for the Third Quarter of Fiscal Year 2020-2021, was recently released.

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The Health Law Firm Blog

MARCH 11, 2024

It provides information and statistics on actions involving licensed health professionals through March 2021. Indest III, J.D., Board Certified by The Florida Bar in Health Law The Florida Department of Health's Quarterly Performance Report (QPR) for the Third Quarter of Fiscal Year 2020-2021, was recently released.

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Verisys

MARCH 1, 2024

As the healthcare industry is increasingly targeted for data theft and fraud, information security has emerged as a top priority for healthcare institutions. Continuously monitoring keeps you in compliance and prevents fraud and abuse within your organization. Healthcare data has never been more susceptible to fraud and abuse.

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Verisys

FEBRUARY 16, 2023

Transition Process Oregon: License Suspensions and Terminations of Orders by Operation of Law and Continuing Education Deficiencies: Oregon Administrative Rule 847-001-0035 has been amended to expand the reasons for which the Executive Director or Medical Director may issue final orders.

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Licensing Nurses Fraud Compliance 52

Provider Trust

JULY 8, 2022

A holistic approach to exclusion monitoring and license verifications must include monitoring of disciplinary databases such as the National Practitioner Data Bank (NPDB). Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S. Who Can Search the NPDB?

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The Health Law Firm Blog

AUGUST 23, 2023

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law All healthcare professionals, including pharmacists and pharmacies, should know the importance of good professional liability insurance. These policies protect them from the financial burden of legal expenses in case of any complaints or lawsuits filed against them.

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Healthcare Compliance Blog

MARCH 28, 2022

An Illinois licensed practical nurse (LPN) was convicted and sentenced for failing to administer lifesaving measures to a resident in a nursing home in 2017. Additionally, the LPN’s nursing license was suspended for an unspecified period of time. Discussion Points: Review your policies and procedures on CPR. Update as needed.

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YouCompli

AUGUST 29, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. Situation One: Before the Pandemic   In April 2019, government officials announced Operation Brace Yourself: a fraud takedown related to telemedicine and durable medical equipment (DME).

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Pharmacy Law Blog

MARCH 13, 2018

To learn about a similar case involving a Florida compounding pharmacy, click here to read one of my prior blogs. The Health Law Firm represents pharmacists and pharmacies in DEA, DOH and FDA investigations, qui tam and whistleblower cases, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits.

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MedTrainer

JANUARY 26, 2024

In this blog, we will outline what is non-compliance in healthcare, highlight various non-compliance activities, and explore how healthcare compliance software plays a crucial role in combating non-compliance.

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Verisys

JULY 27, 2023

This includes licensed and unlicensed staff members, as well as partners, investors, contingent workers, agents, and contractors you do business with. The safety of your patients depends on making sound hiring decisions and ensuring that the licenses of your staff are current.

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Provider Trust

SEPTEMBER 12, 2022

In 2006, New York’s Office of the Medicaid Inspector General (OMIG) was established as an independent office within New York State’s Department of Health to combat fraud and abuse in New York State’s Medicaid program. As far as the numbers go, you might wonder how complete the OMIG List of Restricted and Excluded Providers is.

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Provider Trust

AUGUST 16, 2023

Despite such mandates, OIG investigations over the past five years have found that vendors are accountable for much of the healthcare ecosystem’s fraud, waste, and abuse. Over the past several years, OIG has discovered that a significant amount of fraud, waste, and abuse occurs within the vendor domain.

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