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This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). Book a Demo This year’s report also shows greater participation from managed care organizations (MCOs) as a key trend.
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.
Verisys introduced the Fraud Abuse Control Information System (FACIS) to meet this growing need in 1993. Initially, FACIS aggregated data from licensing boards, the Office of Inspector General (OIG), and other select federal databases. So, don’t delay; schedule a demo of FACIS today! states and jurisdictions.
This includes licensed and unlicensed staff members, as well as partners, investors, contingent workers, agents, and contractors you do business with. The safety of your patients depends on making sound hiring decisions and ensuring that the licenses of your staff are current.
This includes licensed and unlicensed staff members, as well as partners, investors, contingent workers, agents, and contractors you do business with. Not only does thorough screening and rigorous continuous monitoring help ensure quality employees, but it also provides 360-degree transparency.
These exclusions are generally related to criminal activity like fraud or healthcare-related misconduct. Felony convictions for other healthcare-related fraud, theft, or other financial misconduct. Read more about the rollout and accountability of requirements or schedule a demo. . Patient abuse or neglect.
These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. These requirements are designed to protect patient rights, privacy, and safety, as well as to prevent fraud, abuse, and other improper practices within healthcare organizations.
It also helps prevent fraud, abuse, and errors, ensuring the delivery of high-quality care and ethical decision-making. Non-compliance can lead to severe consequences, such as legal penalties, fines, exclusion from government programs, loss of licenses, and even criminal charges for individuals knowingly involved in violations.
Unger, Chief of Medicaid Fraud Division, Office of the Massachusetts Attorney General; and Patrick Callahan, Healthcare Fraud Unit, US Attorney’s Office. It reduced the rate of whistleblower and other fraud complaints, and for Unger at least, abuse cases increased. Request a demo of the YouCompli solution.
Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. Primary source verification is done by contacting educational institutions, licensing boards, and other relevant authorities.
Typically, a pharmaceutical customer master group will verify a healthcare provider’s license and exclusion status. Maintaining a tightly controlled, highly compliant call deck for pharmaceutical reps prevents sampling fraud and protects the company’s employees. Set up an appointment today to learn more.
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