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How To Prepare for an OIG Inspection

MedTrainer

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. Download “Compliance Reports You Can’t Live Without” for OIG reporting templates and tips. What Prompts an OIG Inspection?

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Everything You Need To Know About NPI Numbers

Verisys

The NPI improves the Medicare and Medicaid programs, other federal and private health programs, and the overall effectiveness and efficiency of the healthcare industry by simplifying administration and enabling the efficient electronic transmission of health information. Providers also need an NPI to enroll in Medicare.

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An Overview of the New York OMIG Exclusion List

Provider Trust

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. What is New York's OMIG List of Restricted and Excluded Providers? Who needs to monitor the OMIG List?

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Navigating the Maze of Who Regulates Healthcare Compliance

MedTrainer

Here are some of the key organizations involved in regulating healthcare compliance: Centers for Medicare & Medicaid Services (CMS): CMS is a federal agency within the U.S. Department of Health and Human Services responsible for administering and regulating healthcare programs such as Medicare and Medicaid.

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Preventing Unlicensed Individuals and Subsequent Fraudulent Claims Submission

Provider Trust

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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Privileges and Credentialing Aren’t the Same

MedTrainer

The specialist authenticates the provider’s education, work history, licenses, and other information during provider credentialing. Download Now What are Provider Privileges? Maintaining compliance helps protect against fraud, waste, and abuse. Upon completion and approval, the provider can begin billing for medical services.

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The Importance of Primary Source Verification for Practitioner Credentials

Verisys

State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. Here are some examples: Medical schools verify completion of education. The Primary Source Organizations.