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. That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

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?

Fraud 52

Fraud US Department of Health and Human Services Medicaid Medicaid 52

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.

Nurses 52

Nurses Licensing Fraud Medicaid 52

Health Care Law Brief

JUNE 2, 2022

For the reasons discussed below, DTC telehealth platforms should re-visit their compliance plans and be prepared for increased state and federal regulatory scrutiny. Variety of Risks Present in Telehealth Arrangements. Provider Licenses. Concerns Proliferate for Telehealth Platforms.

Public Health 52

Public Health Compliance COVID-19 Licensing 52

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.

Licensing 52

Licensing Fraud Compliance Nurses 52

Provider Trust

MAY 18, 2022

What the HHS-OIG says about vendor compliance. OIG may exclude the provider if certain circumstances regarding the ownership are present. However, healthcare receives federal funding, and thus OFAC is an additional sanction list that you should add to your vendor compliance plan/program. Case Study: S. Martino-Fleming v.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 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?

Licensing 52

Licensing Malpractice Fraud Compliance 52

Provider Trust

AUGUST 9, 2023

Grimm, the OIG continues its tireless efforts to uncover instances of fraud, waste, and abuse within HHS programs. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders. Led by acting Inspector General Christi A. What is the HHS-OIG Semiannual Report to Congress?

Nursing Homes 52

Nursing Homes COVID-19 Fraud Medicaid 52

Verisys

JANUARY 6, 2022

The OIG through the Social Security Act has the power to bar individuals and entities from receiving federal payments as the result of intentional fraud or abuse. The individual or entity may also request permission to present an oral argument and/or documentary evidence and written argument. Permissive Exclusions.

US Department of Health and Human Services 52

US Department of Health and Human Services Fraud Medicaid Medicaid 52

AIHC

SEPTEMBER 5, 2023

Compliance Considerations for Best Outcomes Written in collaboration with the AIHC Volunteer Education Committee Delivering mental health services via telehealth has increased since the COVID-19 pandemic. This compact does not apply to nurse practitioners (NPs) because they are licensed under state boards of nursing and not medicine.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

Healthcare Compliance Blog

APRIL 6, 2022

The defendant presented the facility staff with falsified documentation indicating that she had performed neurological evaluations throughout the evening. The nurse was sentenced to six months under house arrest and may not seek reinstatement of her license or work in a care facility/home during her five-year supervision period.

Nurses 59

Nurses Nursing Homes Fraud Licensing 59

Hall Render

NOVEMBER 15, 2023

The medical history and physical examination must be completed and documented by a physician (as defined in section 1861(r) of the Act), an oral and maxillofacial surgeon, or other qualified licensed individual in accordance with State law and hospital policy. 42 CFR 482.22 (emphasis added).

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. But state Medicaid exclusion sources are varied and present significant challenges to manual screening processes.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare Law Blog

MAY 31, 2022

These advancements, present challenges and raise novel questions as to how the current healthcare and life sciences legal regime would apply to the metaverse. How healthcare providers are licensed in the metaverse is also an open question. Data Privacy and Security. Licensure and its enforcement can also occur at the state level.

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FDA HIPAA Medicare Medicare 90

C&M Health Law

JUNE 15, 2021

This article was originally published in Corporate Compliance Insights. bribery, fraud, misuse). Health Insurance Portability and Accountability Act (HIPAA) can present several areas of exposure. Both your company’s data supply chain and its physical version have fundamentally similar business risks.

Due Diligence 40

Due Diligence Licensing Informed Consent HIPAA 40

Health Law Advisor

MARCH 1, 2023

On February 14, 2023, the Utah Senate passed a bill that would repeal the State’s “Online Prescribing, Dispensing, and Facilitation Licensing Act” (“Online Prescribing Act”). 2] Statements of Charges may be found on the Washington State Department of Health website, filed under the individual provider’s name and/or license number.

Telemedicine 52

Telemedicine COVID-19 Fraud Licensing 52

Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

Med-Net Compliance

NOVEMBER 1, 2022

South Carolina Attorney General Alan Wilson announced that his office’s Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old woman for allegedly practicing medicine as a registered nurse without a license at seven nursing and assisted living facilities in Anderson, Greenville, and Pickens counties. Update as necessary.

Nursing Homes 59

Nursing Homes Licensing Nurses Fraud 59

Verisys

JULY 13, 2023

How to Tackle Pharma’s 3 Biggest Compliance Risks Head-On with Verisys How often have you started at a new organization and heard these phrases? “ Some companies make decisions based on compliance standards and optics, while others may be more lax. Clinical trial compliance can offer unique challenges for pharmaceutical companies.

Compliance 52

Compliance Due Diligence Pharmaceutical Industry Fraud 52

Verisys

APRIL 27, 2023

If an application is missing key pieces, such as a scan through a primary source or a copy of their license, table the application. Start with quality data As a first step, pre-screening all applicants ensures that only viable applicants are presented to the credentials committee for review. With over 5.5

Malpractice 52

Malpractice Licensing Fraud Medicaid 52

New Jersey Healthcare Blog

JULY 22, 2022

Following a thorough review in compliance with Executive Order No. Additionally, the Board does not offer continuing education on any topic, but rather approves providers who review and present continuing education courses. On April 4, 2022, at 54 N.J.R. 13:44F with amendments. On May 2, 2022, at 54 N.J.R. On May 2, 2022, at 54 N.J.R.

COVID-19 Vaccine 40

COVID-19 Vaccine Licensing COVID-19 Public Health 40

Hall Render

MARCH 3, 2023

million for youth mental health care KENTUCKY Pike County nursing home officials release statement following loss of Medicare agreement Three Humana executives drop $11.2M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

FEBRUARY 18, 2022

License wait times reach crisis levels for healthcare workers. Only 14% of Hospitals Met Price Transparency Rule Compliance. Florida physician convicted of $110M fraud. Lack of ICU doctors presents challenges for healthcare in Idaho. billing fraud. 3 Texas medical labs charged in $300M fraud scheme.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

FEBRUARY 24, 2023

medical workers 4 takeaways from Braselton hospital expansion presentation HAWAII Hawaii Gov. Staff shortages could spur next public health crisis, Baystate Health CEO warns CommonSpirit, Mass General, Moffitt execs to judge telehealth challenge Brigham and Women’s, AI company get $2.5M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

MARCH 24, 2023

Reeves’ desk. Here’s what they are.

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Drug & Device Law

DECEMBER 29, 2023

2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. Negligence requires an evaluation of a defendant’s reasonableness, and all relevant NC authority includes relevant regulatory compliance in that mix. Plaintiffs’ own litigation strategy thus opened the door to compliance evidence. Monsanto Co. , denied , 144 S.

FDA 105

FDA US Department of Health and Human Services COVID-19 Informed Consent 105

Drug & Device Law

NOVEMBER 1, 2022

Starting with the to-be-published Mixson I , this IVC filter case presented rather complex choice of law issues because the plaintiff implantee was in the military when the surgery in question occurred, and the army sent him to Texas for treatment, even though he was a Florida resident. 2022 WL 4364153, at *2.

FDA 59

FDA Fraud Licensing Governance 59

Drug & Device Law

AUGUST 8, 2022

For qualified IMGs, it issues a certification, which IMGs can then use to apply to residency and other graduate medical education programs and to apply for state medical licenses. The unfortunate truth is that ECFMG was also a victim of this fake doctor’s fraud. has no power to enforce compliance”), aff’d , 405 F. 471 (11th Cir.

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Doctors Fraud Licensing Compliance 52