The Health Law Firm Blog

APRIL 18, 2022

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.].

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Provider Trust

APRIL 26, 2023

However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. A travel nurse could be hired to work at a hospital located in a state where they are not licensed to practice. For starters, each state has its own process, rules, and regulations for monitoring licensed nurses.

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Provider Trust

JUNE 1, 2022

Organizations across the healthcare continuum have experienced several workforce trends that are creating gaps in license monitoring and verifications. In this post, we’ll explore three current challenges impacting the healthcare license and credential verification process. See our Telehealth Credentialing Guide for more information.

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Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

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The Health Law Firm Blog

AUGUST 22, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

JULY 17, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

AUGUST 8, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

JUNE 26, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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Verisys

DECEMBER 8, 2022

A professional career can take a provider across state lines, and through an evolution of various license types. In order to see the full picture of an individual, the comprehensive whole of each state licensing board across all license types must be searched. Take the process back another step.

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Provider Trust

MARCH 13, 2023

State licensing boards nationwide have annulled the licenses of dozens of nurses who obtained fake degrees and used them to gain or secure employment. In Delaware, 26 nursing licenses were revoked when the nurses’ credentials were tied to the scheme. ProviderTrust recommends conducting license verification monthly.

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The Health Law Firm Blog

JANUARY 2, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On October 18, 2023, an ex-Navy officer was sentenced to 30 months in prison after he pleaded guilty to conspiracy to commit wire fraud for his role in an [.] Indest III, J.D.,

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Provider Trust

JANUARY 26, 2022

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?

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Verisys

AUGUST 13, 2024

Verisys is a trusted partner that ensures the safety of your business from potential risks and guarantees the validation of identities, licenses, and absence of sanctions, exclusions, or debarments within your business network, enabling you to secure your path to success. The post July 2024 Bad Actors Roundup appeared first on Verisys.

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Verisys

AUGUST 13, 2024

Verisys is a trusted partner that ensures the safety of your business from potential risks and guarantees the validation of identities, licenses, and absence of sanctions, exclusions, or debarments within your business network, enabling you to secure your path to success. The post July 2024 Bad Actors Roundup appeared first on Verisys.

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Verisys

MAY 13, 2024

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Here is a round up of bad actors: Doctor sentenced to 10 years in prison for unlawfully dispensing controlled substances ( Full Story ) Doctor Convicted for $5.4M

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Verisys

APRIL 2, 2024

Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Million Medicare Fraud Scheme ( Full Story ) New York-Presbyterian/Brooklyn Methodist Hospital Settles Health Care Fraud Claims for $17.3 Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Secure your success by choosing Verisys.

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Verisys

JULY 25, 2024

Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 The post June 2024 Bad Actors Roundup appeared first on Verisys.

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Verisys

JULY 25, 2024

Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 The post June 2024 Bad Actors Roundup appeared first on Verisys.

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Verisys

JUNE 17, 2024

Verisys is a trusted partner that ensures the safety of your business from potential risks and guarantees the validation of identities, licenses, and absence of sanctions, exclusions, or debarments within your business network, enabling you to secure your path to success. Attorney Announces $2.5 Attorney Announces $2.5

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Verisys

JANUARY 2, 2024

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Secure your success by choosing Verisys.

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Verisys

FEBRUARY 9, 2024

Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

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Provider Trust

JANUARY 18, 2023

In October 2022, the South Carolina Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old South Carolina woman named Alyssa Beth Steele for working as a registered nurse despite not having a license. Pursuant to federal regulations, the SCMFCU is authorized to investigate and prosecute any acts of Medicaid provider fraud.

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MedTrainer

JULY 28, 2023

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. But what exactly is considered fraud, waste, and abuse? These complaints can trigger an audit. Data Analysis and Trends.

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Provider Trust

AUGUST 6, 2024

These three factors each contribute to your overall impact on eradicating fraud, waste, and abuse within the healthcare system. At a minimum, you should verify the licenses and credentials of every provider employed at your organization at hire and expiration. See Our Impact Compliance Program 1. What about vendors?

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Verisys

FEBRUARY 8, 2024

Here’s how Verisys can support pharmaceutical manufacturers in this critical area: Comprehensive Background Screening and Credentialing: Verisys’ FACIS (Fraud and Abuse Control Information System) is a key tool for screening and continuous monitoring of healthcare providers.

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MedTrainer

FEBRUARY 5, 2024

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. The information confirms a provider is currently licensed to practice medicine.

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Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.

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MedTrainer

JANUARY 12, 2024

In this blog post, we’ll outline who regulates healthcare compliance, how rules are enforced, and why organizations need a robust compliance platform to stay in the good graces of regulators. Department of Health and Human Services focuses on preventing fraud, abuse, and waste in federal healthcare programs.

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Verisys

NOVEMBER 8, 2023

The NPI does not replace other identification numbers such as a provider’s taxpayer identification number (TIN), Drug Enforcement Administration registration, license number, or Social Security number. Tracking actions to a standardized identifier provides transparency that can identify and impede fraud.

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MedTrainer

SEPTEMBER 5, 2024

In an effort to prevent fraud, the Drug Enforcement Agency (DEA) implemented additional security for their Registrant Validation Toolset. In this blog post, I’ll explain what changed, how to know if you’re compliant, and why this change will be beneficial for your organization (even if it doesn’t seem like it right now!).

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Hall Render

FEBRUARY 8, 2023

Department of Justice (“DOJ”) charged over two dozen individuals with wire fraud and conspiracy to commit wire fraud in connection with leading the alleged fraudulent scheme – each defendant faces up to 20 years in prison. Hall Render blog posts and articles are intended for informational purposes only.

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Provider Trust

AUGUST 9, 2022

The Health Care Fraud and Abuse Control Program (HCFAC) protects patients and consumers by combating healthcare fraud and abuse. During the fiscal year 2021, the report states that the federal government won or negotiated over $5 billion in healthcare fraud judgments and settlements. Monetary Penalties. Key Takeaways. $5

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MedTrainer

FEBRUARY 12, 2024

In this blog, we’ll outline why reporting healthcare non-compliance is non-negotiable and how software platforms make it easier to stay in compliance with the myriad regulations that govern good healthcare. Non-compliance can lead to significant fines, legal battles, and the loss of license or accreditation.

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Healthcare Compliance Blog

MARCH 10, 2022

Complaints of resident abuse in a Michigan nursing home led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursing home while her license was suspended, which is a felony.

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MedTrainer

JUNE 10, 2024

Domestic violence training is required based on licensing. Included in this blog post are the results of an audit on California requirements. Provide required and often hard-to-find CE courses for licensed employees. This list should be used as a guide and does not replace your own comprehensive analysis.

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MedTrainer

JULY 30, 2024

Included in this blog post are the results of an audit on Wisconsin requirements. Provide required and often hard-to-find CE courses for licensed employees. Clearly healthcare organizations take Wisconsin training requirements seriously. This list should be used as a guide and does not replace your own comprehensive analysis.

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Hall Render

OCTOBER 20, 2023

The application must include the following: A cover letter identifying the facility or institution, address, county and number and type of beds licensed by the Connecticut Department of Public Health. The CHOW Law creates new change of ownership requirements for health care providers.

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