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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. Data Analysis and Trends.

Fraud 98
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Ongoing License Monitoring Critical to Prevent Healthcare Fraud

Provider Trust

A 49-year-old Brownsville, TX man named Fernando Mendez was taken into custody in early September after being charged with defrauding Medicaid. From August 2021 to February 2022, Mendez provided patient assessments and evaluations and ordered treatments and prescriptions, all while billing Medicaid for his services.

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Attention New York Medicaid Providers: It’s Time to Upgrade Your Compliance Program

Healthcare Law Blog

Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1] New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R.

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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. Learn More About NPIs When Did NPI Numbers Begin?

Fraud 97
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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?

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How OIG Exclusion List Monitoring Promotes Patient Safety

MedTrainer

This list includes individuals convicted of healthcare fraud, patient abuse, or other serious violations. Download Now Exclusion Checks vs. Exclusion Monitoring Same concept, different strategy, different outcomes. This proactive approach safeguards those under your care and builds trust between patients and healthcare providers.

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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.