Blog 1 Column Post

Blog 1 Column Post

I Have a Confirmed Exclusion What are my Options

After finding a confirmed exclusion among your employees, vendors, contractors, or volunteers there are several options you can take. Each…

Massachusetts Medicaid Exclusion Screening Requirements

Massachusetts Medicaid Exclusion Screening: Requirements and Best Practices for Compliance The Massachusetts Medicaid Exclusion requirements, under MassHealth, will not reimburse…

Can a Medicare Provider or Supplier Hire an Excluded Individual or Enter in a Contract with an Excluded Entity on the Medicare Exclusion List?

Should you choose to participate in the Medicare and/or Medicaid programs, you must comply with a wide variety of program…

Pennsylvania Doctor Excluded in Connection with Quality of Care

Over the past year, both State and Federal law enforcement investigators and prosecutors have gone to considerable lengths to publicize…

OIG Semiannual Report to Congress: Fall 2018-Spring 2019

The Office of Inspector General (OIG) recently published its Semi-Annual Report to Congress covering from October 1, 2018 to March…

States With Separate Exclusion Databases

The Center for Medicare and Medicaid Services (CMS) retains overall responsibility for the Medicaidprogram, but States have final authority on…

Alabama Exclusion Screening Requirements

(May 2, 2019) The Alabama Medicaid Program imposes significant exclusion screening requirements on its providers.  Many are unaware of the extent…

California Exclusion List Screening Requirements

What are the California Exclusion List Screening requirements?  The Medi-Cal Program will not pay for any item or service furnished…

New Evidence Shows the Efficiency and Benefits of Using an Internal Compliance Hotline System

(April 4, 2019):  In December of 2018 a study was conducted by Kyle Wench (George Washington University) and Stephen Stubben…

OIG Enforcement Actions: Notable Decisions from March 2019

(April 2, 2019) The Department of Health and Human Services (HHS), Office of Inspector General (OIG), has continued its goal…