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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. This ensures that medical facilities are not engaging in malpractice and following program rules and regulations.

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Medical Compliance Plans Limit Healthcare Liability

MedTrainer

Here’s how these plans help limit liability: Prevent Fraud and Abuse: Compliance plans include measures to prevent fraud and abuse within the healthcare organization. Reduce Medical Malpractice Risk: Ensuring patient safety is a fundamental component of compliance plans.

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8 Common Provider Credentialing Mistakes and How to Avoid Them

Verisys

Hospitals or health systems may not allocate adequate resources or staff to complete the medical credentialing process. 3: Allowing a physician to treat patients before credentialing is completed Courts have held hospitals liable when a physician falsifies credentials, and the hospital fails to do its due diligence in verifying them.

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Quick Guide to the National Practitioner Data Bank (NPDB)

Provider Trust

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.

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Privileges and Credentialing Aren’t the Same

MedTrainer

Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Courtesy: This is when a hospital occasionally allows a provider to admit and treat a patient. However, not all providers need hospital privileges.

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Effective Corporate Compliance in a Healthcare Facility

MedTrainer

Clinical Risks: These are associated with patient care and can include malpractice claims, costs of corrective procedures, and increased insurance premiums resulting from adverse patient outcomes. Financial Risks: They encompass losses from billing errors, fraud, and abuse claims, or failed investments related to healthcare provisions.

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Private Equity: Investigation and Enforcement

Med Law Blog

Please note that the potential for ulterior financial motives does not automatically presume that the intent is somehow suspect, in the same way that potential medical malpractice concerns does not legitimately question the clinical motives of all other providers. in United States ex rel.