Are You the Target of a Medicaid Audit? Tips Health Professionals Should Be Following
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), and Bureau of Medicaid Program Integrity is the Florida agency responsible for routine Medicaid audits The agency ensures that the Medicaid program was billed correctly for […]
OIG Exclusion: Do You Know if You’re on the List?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health La Have you ever faced a disciplinary action against your professional license? Have you ever been arrested or convicted of a criminal offense? If yes, then you may have also been terminated from the federal Medicare Program or your […]
OIG Exclusion: What You Need to Know if You’re on the List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Have you ever had disciplinary action against your license as a health care professional? Have you ever been arrested or convicted of a criminal offense? Have you ever been convicted of fraud or patient neglect? If so, then […]
Copying and Pasting Clinical Notes in Electronic Health Records Could Be Considered Healthcare Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Health and Human Services (HHS) Office of Inspector General (OIG) is concerned about healthcare providers carelessly copying and pasting clinical notes in electronic health records (EHRs). According to an audit report released on December 10, […]
OIG Audit Finds Federal Database of Terminated Medicaid Providers Needs Improvement
By Lenis L. Archer, J.D., M.P.H., The Health Law Firm The Affordable Care Act (ACA) requires the Centers for Medicare and Medicaid Services (CMS) to establish a process for sharing information about terminated Medicaid providers. The federal database, called Medicaid and Children’s Health Insurance Program State Information Sharing System (MCSIS), is designed to prevent terminated […]
New OIG Guidance Publishes on Permissive Exclusions from Federal Health Care Program Participation May Interest Mental Health Care Professionals
By Miles Indest, J.D./M.B.A candidate at Tulane University: Law Clerk, The Health Law Firm On April 20, 2016, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released updated non-binding criteria that disclosed when a company or individual can be barred from participating in Medicare, Medicaid, and other federal health care […]
OIG Issues Advisory Opinion to Specialty Pharmacy for Support Service Payments
By Lenis L. Archer, J.D., M.P.H., The Health Law Firm There is an inherent risk in entering into financial arrangements where payments to a service provider are only made when a referral is generated. On August 15, 2014, the Office of Inspector General (OIG) made this perfectly clear in an unfavorable advisory opinion issued to […]