Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? But these programs cannot be controlled by Medicaid and Medicare alone. But these programs cannot be controlled by Medicaid and Medicare alone. With this legislation, Medicaid Fraud Control Units (MFCUs) were born.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

The Health Law Firm Blog

JULY 11, 2022

Board Certified by The Florida Bar in Health Law Do you have a medical, pharmacist, counselor, or nursing license in more than one state? Do you have a license in more than one profession? By George F. Indest III, J.D., Have you been notified that an investigation has been opened against your professional [.].

Licensing 52

Licensing Nurses Medicaid Medicaid 52

Physician Credentialing Company

NOVEMBER 21, 2024

Insurance credentialing is the verification process in which credentials like educational degrees, licenses, training certificates, and work experience are evaluated to determine whether a specific provider can provide standard care to insured patients or not. We will also discuss the documents needed and various credentialing challenges.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

The Health Law Firm Blog

SEPTEMBER 20, 2023

Board Certified by The Florida Bar in Health Law Florida's Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. Indest III, J.D., On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against [.]

Medicaid 52

Medicaid Medicaid Overpayment Overpayments 52

The Health Law Firm Blog

AUGUST 24, 2023

Board Certified by The Florida Bar in Health Law Florida's Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. Indest III, J.D., On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against [.]

Medicaid 52

Medicaid Medicaid Overpayment Overpayments 52

The Health Law Firm Blog

JULY 19, 2023

Board Certified by The Florida Bar in Health Law Florida's Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. Indest III, J.D., On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against [.]

Medicaid 52

Medicaid Medicaid Overpayment Overpayments 52

The Health Law Firm Blog

JUNE 27, 2023

Board Certified by The Florida Bar in Health Law Florida's Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. Indest III, J.D., On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against [.]

Medicaid 52

Medicaid Medicaid Overpayment Overpayments 52

The Health Law Firm Blog

MAY 16, 2023

Board Certified by The Florida Bar in Health Law Florida's Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. Indest III, J.D., On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against [.]

Medicaid 52

Medicaid Medicaid Overpayment Overpayments 52

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. Additionally, there are varying, disparate State Medicaid exclusions sources that require periodic screening.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Verisys

OCTOBER 8, 2024

Starting August 26, 2024, out-of-state physicians who have received a license from a compact state and a corresponding “letter of qualification” can apply to the IMLC to designate Pennsylvania as a state where the physician wants to practice and apply for expedited licensure from the relevant state licensing board.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Medicaid 52

Verisys

OCTOBER 8, 2024

Starting August 26, 2024, out-of-state physicians who have received a license from a compact state and a corresponding “letter of qualification” can apply to the IMLC to designate Pennsylvania as a state where the physician wants to practice and apply for expedited licensure from the relevant state licensing board.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Medicaid 52

The Health Law Firm Blog

MAY 12, 2023

Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Indest III, J.D., The office manager for Universal Smiles, a D.C.-based based dental practice was sentenced for her [.]

Medicaid 52

Medicaid Medicaid Fraud Licensing 52

MedTrainer

MARCH 30, 2024

Built-in Automation Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration. Choose software with dynamic graphs that show application age, average time to complete applications, and number of closed applications per credentialer.

Malpractice 98

Malpractice Licensing Medicaid Medicaid 98

Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare. As such, providers should prioritize billing compliance.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

MedTrainer

MAY 7, 2024

This blog will highlight how credentialers can navigate UnitedHealthcare provider enrollment. Completing UnitedHealthcare provider enrollment is no different. Credentialers understand the importance of working with insurance payers to ensure smooth and timely reimbursement. It’s a challenge.

Malpractice 52

Malpractice Licensing Medicaid Medicaid 52

Pharmacy Law Blog

MAY 14, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

Licensing 40

Licensing Nurses Medicaid Medicaid 40

Pharmacy Law Blog

MAY 7, 2018

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license: 1.

Licensing 40

Licensing Nurses Medicaid Medicaid 40

Physician Credentialing Company

JULY 23, 2024

In this blog, we will delve deep into the details of hospital credentialing steps, their importance, and the obstacles in undergoing this process. If candidates get approved by the credentialing committee, they are presented with a medical practicing license to work in a specific healthcare department.

Hospitals 52

Hospitals Licensing Malpractice Doctors 52

The Health Law Firm Blog

FEBRUARY 15, 2022

Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Indest III, J.D., The office manager for Universal Smiles, a D.C.-based based dental practice was sentenced for her.

Medicaid 52

Medicaid Medicaid Fraud Licensing 52

MedTrainer

APRIL 11, 2024

This blog will discuss potential healthcare credentialing challenges, strategies to prevent these problems, and how credentialing software makes the process efficient and effective. Noncompliance: Providers must maintain specific licenses and certifications to provide patient care services. What Is Healthcare Credentialing?

Licensing 52

Licensing Medicaid Medicaid Medicare 52

MedTrainer

MAY 30, 2024

Traditionally, credentialers call the appropriate entities to verify transcripts, licenses, etc. Multiple Data Sources : Information comes from state licensing boards, educational institutions, previous employers, and professional organizations. Many other challenges in the process require organization, persistence, and documentation.

Licensing 52

Licensing Malpractice Medicare Medicare 52

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.

Nurses 52

Nurses Licensing Fraud Medicaid 52

Physician Credentialing Company

OCTOBER 25, 2024

For example, a psychotherapist who has a professional practicing license might embrace the cognitive-behavioral approach to urge the patient to overcome negative thinking methods. Only licensed mental health professionals are permitted to send the bill for the services offered defined by code 90834. Who can Bill CPT Code 90834?

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

The Health Law Firm Blog

DECEMBER 3, 2023

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.]

Licensing 40

Licensing Governance Health Care Lawyers Medicaid 40

MedTrainer

DECEMBER 4, 2023

The Kentucky Cabinet for Health and Family Services (CHFS), Department for Medicaid Services administers the state’s Medicaid program, ensuring access to essential health care services for eligible low-income individuals and families in Kentucky. The residency training lcense supports medical practice during residency.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

The Health Law Firm Blog

SEPTEMBER 8, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.].

Licensing 52

Licensing Governance Health Care Lawyers Medicaid 52

Provider Trust

NOVEMBER 20, 2024

Note that this doesn’t call for monthly monitoring of all credential information—only monthly monitoring of the license expiration date, which most payers don’t have an infrastructure to support. And monitoring license expiration dates isn’t as simple as it may sound.

Licensing 52

Licensing Compliance Medicaid Medicaid 52

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.

Compliance 52

Compliance Licensing Governance Fraud 52

The Health Law Firm Blog

SEPTEMBER 8, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved [.].

Licensing 52

Licensing Governance Health Care Lawyers Medicaid 52

MedTrainer

NOVEMBER 27, 2023

The Ohio Department of Medicaid is responsible for administering the state’s Medicaid, a comprehensive healthcare program that provides medical coverage to low-income individuals and families in Ohio. This department focuses on ensuring access to quality healthcare services while managing the state’s Medicaid budget and policies.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Provider Trust

SEPTEMBER 12, 2022

In 2006, New York’s Office of the Medicaid Inspector General (OMIG) was established as an independent office within New York State’s Department of Health to combat fraud and abuse in New York State’s Medicaid program. No payments will be for medical care, services and supplies furnished, prescribed, or ordered by an excluded party.

Medicaid 52

Medicaid Medicaid Fraud Licensing 52

MedTrainer

NOVEMBER 27, 2023

The Division of Health Benefits administers the state’s Medicaid program, which provides essential healthcare coverage to eligible individuals and families. Providers must be licensed in North Carolina, except under certain conditions, and must ensure that services align with their scope of practice. Medicaid expansion under H.B.

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

MedTrainer

NOVEMBER 27, 2023

The Department of Community Health (DCH) serves as the lead agency for Medicaid and PeachCare for Kids® , and also oversees the State Health Benefit Plan , Healthcare Facility Regulation Division and State Office of Rural Health. The Medical Assistance Plans Division oversees Georgia’s Medicaid and PeachCare for Kids® programs.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

FEBRUARY 5, 2024

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. The information confirms a provider is currently licensed to practice medicine.

Licensing 52

Licensing Governance Compliance Fraud 52

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

Fraud 52

Fraud Medicaid Medicaid Medicare 52

MedTrainer

MAY 6, 2024

This blog will highlight how credentialers can navigate Aetna provider enrollment. Built-in Automation: Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration.

Licensing 52

Licensing Malpractice Health Insurance Medicaid 52

MedTrainer

FEBRUARY 20, 2024

In this blog, we’ll review what is insurance credentialing, the process, and who’s required to complete insurance credentialing. While these professions do require credentialing, many other licensed healthcare providers require insurance credentialing as well. There are many steps to this time-consuming process.

Licensing 52

Licensing Medical Billing Compliance Medicaid 52