Fraud Governance Malpractice Medicaid 
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. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers.
MedTrainer
FEBRUARY 5, 2024
Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. The employer may also review any pending and past medical malpractice cases or disciplinary actions. We’ll also review why both processes are vital for healthcare organizations.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Verisys
AUGUST 31, 2023
Here are seven red flags to look out for and the reasons why: Incomplete or inconsistent application: Missing or conflicting data regarding education, training, work history, licensure, or malpractice history might indicate false information or attempts to conceal relevant details.
Verisys
DECEMBER 5, 2023
An Office of Inspector General (OIG) search of the List of Excluded Individuals/Entities (LEIE) indicates if the licensee is excluded from participating in government-funded programs. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs.
Provider Trust
JULY 8, 2022
In this quick guide, we’ll explore the importance of including NPDB monitoring in your routine license and exclusion monitoring to protect your organization and the patients you serve from fraud, waste, and abuse. Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S.
MedTrainer
MARCH 14, 2024
Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Whether it’s government regulation or healthcare facility requirements is a matter. Maintaining compliance helps protect against fraud, waste, and abuse.
AIHC
SEPTEMBER 5, 2023
Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This includes understanding various fraud and abuse laws.
Expert insights. Personalized for you.
98 
Let's personalize your content