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Technologies continue to transform the healthcare industrythe da Vinci Surgical Robot performs precise movements that enable minimally invasive surgeries, the CyberKnife delivers targeted radiotherapy, and smart devices provide practitioners with instantaneous updates to patient health. What Is AI in Healthcare 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.
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Three schools across Broward County and Palm Beach County, Florida, were involved in this multimillion-dollar fake diploma scheme: Siena College of Health, Palm Beach School of Nursing, and Sacred Heart International Institute. In addition, an estimated 37 percent of student nurses with fake diplomas passed the NCLEX.
A Massachusetts home health aide, who was licensed as a Certified Nursing Assistant (CNA), has been indicted in connection with a home surveillance video showing her abusing an elderly patient, Attorney General Maura Healey announced. This also may indicate possible abuse.
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.
The onboarding process is pivotal in ensuring employees understand their job duties, engage in best cybersecurity practices, and comply with important regulations like the Health Insurance Portability and Accountability Act, Occupational Health and Safety Administration, and prevention of Fraud, Waste, and Abuse in healthcare.
An individual or entity excluded under section 1128(b)(4) of the Social Security Act, whose period of exclusion is indefinite, may apply for reinstatement when they have regained the license referenced in the exclusion notice. Reinstatement of an excluded individual or entity is not automatic once the specified period of exclusion ends.
Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and HumanServices Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.
Federal payments for healthcare services account for 28% of all healthcare spending in the United States. The List of Excluded Individuals/Entities (LEIE) is maintained by the Department of Health and HumanServices (HHS) Office of the Inspector General ( OIG) and dictates which providers are excluded from receiving federal funds.
Whether you use paper, spreadsheets, email, or fax, the credentialing process can be long and frustrating when you’re doing it internally. It’s important for a practitioner to be credentialed and have privileges granted before beginning to practice medicine and bill for services rendered. What’s the solution?
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It supports compliance with laws like the Health Care Quality Improvement Act and standards set by accrediting bodies such as The Joint Commission. These processes verify that nurses possess valid, unrestricted licenses and necessary certifications to practice legally and safely.
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