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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. HHS-OIG will continue to work with the US Attorney’s Office to ensure the integrity of the Medicare Trust Fund.”.

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Compliance Risks Associated with Outlier Payments 

YouCompli

Compliance officers can help protect revenue and reduce the risk of penalties by collaborating with the Finance and Reimbursement departments to navigate the dynamics of outlier payments and prospective repayment. Leverage OIG reports to protect healthcare revenue. Price increases can sometimes result in inappropriate outlier payments.

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Avoiding “Gotcha” Moments in Compliance 

YouCompli

Unfortunately, with a title like “compliance officer,” we have some image issues to overcome if we want our healthcare leaders to see us more like a business partner and less like an obstacle. Let’s imagine someone is conducting an audit involving the review of medical-necessity documentation for physical therapy services.

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Improving Patient Care With a “Prevent, Detect, Report” Strategy  

YouCompli

Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic. For example, they can describe how to read a billing statement and identify services or supplies that were not provided.