Remove Fraud Remove Licensing Remove Medicare Remove US Department of Health and Human Services
article thumbnail

Nursing Home Psychologist Convicted of Healthcare Fraud Scheme

Med-Net Compliance

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. The psychologist was convicted of four counts of healthcare fraud.

article thumbnail

How Serious are OIG Exclusions? Key Insights into the Fraud Risk Spectrum

Provider Trust

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? Department of Justice (DOJ), the U.S.

Fraud 52
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

The Department of Health and Human Services once again (for the ninth time) extended the public health emergency this past month , stretching it beyond mid-July. But sooner or later, that provision of the Public Health Service Act will draw to a close. We spoke recently with Allison M.

article thumbnail

Sanctions and penalties for hiring excluded individuals in healthcare 

YouCompli

Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.

Fraud 52
article thumbnail

Applying for Reinstatement after OIG Exclusion

Med-Net Compliance

In order to participate in the Medicare, Medicaid, and all federal healthcare programs once the term of exclusion ends, the individual or entity must apply for reinstatement and receive written notice from OIG that reinstatement has been granted. An individual or entity with a defined period of exclusion (e.g., 5 years, 10 years, etc.)

article thumbnail

How to Be Removed from the OIG Exclusion List

Verisys

Federal payments for healthcare services account for 28% of all healthcare spending in the United States. Payments from Medicare, Medicaid, TRICARE, CHIP, and other federal programs are a significant source of funds for nearly every healthcare organization and provider. There are two types of OIG exclusions : permissive and mandatory.

article thumbnail

What Is Corporate Compliance in Healthcare?

MedTrainer

Dive with us as we explore the complexities and necessities of compliance in the healthcare sector. Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a pivotal regulation that focuses on the protection of patient health information, enforced by the U.S. Department of Health and Human Services (HHS).