Provider Trust

JULY 8, 2022

In this quick guide, we’ll explore the importance of including NPDB monitoring in your routine license and exclusion monitoring to protect your organization and the patients you serve from fraud, waste, and abuse. Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S.

Licensing 52

Licensing Malpractice Fraud Medicaid 52

Hall Render

JUNE 3, 2024

In addition to litigation, Katie focuses on matters related to government investigations, the False Claims Act and fraud and abuse. Before joining Hall Render, Katie gained hands-on litigation experience in medical malpractice defense, product liability and premises liability cases.

Malpractice 40

Malpractice Licensing Fraud Governance 40

MedTrainer

SEPTEMBER 5, 2024

This confidential clearinghouse primarily aims to safeguard public interest and healthcare quality while reducing fraud and abuse. Health organizations must complete National Practitioner Data Bank or NPDB credentialing to maintain compliance with federal regulations.

Malpractice 52

Malpractice Fraud Licensing Compliance 52

Verisys

AUGUST 31, 2023

Here are seven red flags to look out for and the reasons why: Incomplete or inconsistent application: Missing or conflicting data regarding education, training, work history, licensure, or malpractice history might indicate false information or attempts to conceal relevant details.

Malpractice 52

Malpractice Fraud Medicaid Medicaid 52

Total Medical ComplianceHIPAA

JANUARY 11, 2024

These screenings search through various databases containing records of individuals or organizations barred from participating in Medicaid, Medicare, or other federal/state healthcare programs due to fraud, abuse, or other offenses. Why is Sanction Screening Vital Under HIPAA?

HIPAA 52

HIPAA Malpractice Regulatory Compliance Compliance 52

Physician Credentialing Company

JULY 15, 2024

By validating staff competence, it reduces the likelihood of malpractice claims and legal issues. This process reduces the risk of fraud and ensures accuracy. It also involves checking for any disciplinary actions or malpractice history. There are also checks for malpractice history and criminal background.

Malpractice 52

Malpractice Compliance Licensing Medical Billing 52

Verisys

JULY 20, 2023

This creates the potential for adverse patient outcomes, leading to expensive malpractice lawsuits. However, an even better source is an aggregated dataset such as Verisys’ FACIS (Fraud Abuse Control Information System). Thorough and ongoing provider screening is critical to avoid costly negligent credentialing and malpractice claims.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

MedTrainer

FEBRUARY 5, 2024

The employer may also review any pending and past medical malpractice cases or disciplinary actions. This helps uphold quality healthcare standards and protects against fraud, waste, and abuse. Complying with laws regarding fraud, waste, and abuse also helps to reduce unnecessary expenditures.

Licensing 52

Licensing Governance Compliance Fraud 52

MedTrainer

NOVEMBER 14, 2023

Clinical Risks: These are associated with patient care and can include malpractice claims, costs of corrective procedures, and increased insurance premiums resulting from adverse patient outcomes. Financial Risks: They encompass losses from billing errors, fraud, and abuse claims, or failed investments related to healthcare provisions.

Compliance 52

Compliance Compliance Officers Fraud Malpractice 52

Compliancy Group

OCTOBER 17, 2023

By adopting an enterprise risk management framework, healthcare entities can identify potential financial risks such as: Revenue loss due to billing errors or fraud Increased expenses related to malpractice claims or litigation settlements Reimbursement challenges Through proactive mitigation strategies outlined within the enterprise risk management (..)

Regulatory Compliance 52

Regulatory Compliance Compliance Malpractice Fraud 52

MedTrainer

MARCH 14, 2024

Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Maintaining compliance helps protect against fraud, waste, and abuse. Upon completion and approval, the provider can begin billing for medical services.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

AIHC

SEPTEMBER 5, 2023

The practice of telehealth raises many questions regarding malpractice liability including informed consent (addressed in more detail below), practice standards and protocols, supervision requirements for nonphysician providers, and the provision of professional liability insurance coverage.

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

MedTrainer

AUGUST 2, 2023

It involves collecting and reviewing information such as education, training, licensure, certifications, work history, malpractice history, and references — all in pursuit of verifying that providers are who they say they are and qualified to deliver legitimate, safe, and ethical care.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Verisys

APRIL 27, 2023

Verisys’ proprietary dataset, Fraud Abuse Control Information System (FACIS) , is the largest and most comprehensive dataset for screening allied health and medical providers. As a credentialing verification organization , Verisys has a variety of solutions that can meet your organization’s credentialing needs. With over 5.5

Malpractice 52

Malpractice Licensing Fraud Medicaid 52

AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

Compliance 52

Compliance Fraud Medicare Medicare 52

Med Law Blog

MAY 1, 2023

Please note that the potential for ulterior financial motives does not automatically presume that the intent is somehow suspect, in the same way that potential medical malpractice concerns does not legitimately question the clinical motives of all other providers.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

Compliancy Group

JANUARY 18, 2022

This does not include the potential cost of damage to the practice’s reputation if those ransomed records containing PHI were sold for use in payment fraud or identity theft. In light of these growing threats, we are at or near a point where cyber liability insurance is as essential as malpractice insurance or business liability insurance.

HIPAA 52

HIPAA Compliance Ransomware Malpractice 52

Verisys

DECEMBER 5, 2023

The policy issuer for malpractice insurance verifies insurance coverage. As compliance requirements change to keep up with ever-evolving, accelerating fraud schemes and high expectations for quality care and outcomes, they place increasing demands on healthcare facilities. Credentials Verification Organizations to the Rescue?

Governance 52

Governance Licensing Malpractice Medicaid 52

Verisys

MARCH 1, 2022

The policy issuer for malpractice insurance verifies insurance coverage. As compliance requirements change to keep up with ever-evolving, accelerating fraud schemes and high expectations for quality care and outcomes, they place increasing demands on healthcare facilities. Credentials Verification Organizations to the Rescue?

Governance 52

Governance Licensing Malpractice Medicaid 52

Hall Render

MAY 13, 2022

Prism pays $650K to settle Medi-Cal fraud claims filed in San Diego. Judge awards $5 million to NH woman in medical malpractice case. Covid-19 continues climbing in state. Oscar Health To Exit Colorado, Arkansas. Arkansas Sues Drugmakers, Pharmacy Benefit Managers Over Insulin Costs. CALIFORNIA. Nevada to lift emergency declaration.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

APRIL 29, 2022

California to increase awards in medical malpractice cases. in malpractice case. Doctor overseeing coronavirus testing at BWI accused of health-care fraud. Owners Of Behavioral Health Companies Sentenced For Medicaid Fraud. Nurses at 9 Tenet hospitals in California to raise awareness over staffing, turnover. Here’s why.

COVID-19 40

COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Verisys

FEBRUARY 10, 2022

Malpractice Certification of Insurance. Verify organizational information (board, Drug Enforcement Administration registration, malpractice insurance, etc.) Restrictions may be placed upon a practitioner’s license for civil or legal violations as well as discipline imposed by the medical board. . Professional Affiliations.

Licensing 52

Licensing US Department of Health and Human Services Malpractice Compliance 52

Hall Render

SEPTEMBER 23, 2022

million to resolve Medicare fraud claims. Vendor sues to identify mystery owners of shuttered nursing home so it can sue for fraud. fraud scheme. Former top Mississippi health official pleads guilty to fraud. NH lawmakers launch review of Board of Medicine amid hospital malpractice reports. Akorn to pay $7.9

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

DECEMBER 22, 2023

fraud scheme UConn Health is in financial trouble. Alexius Devils Lake Hospital renovations Closing the Medicaid Gap Is Just the First Step, as Nursing Homes Fight for Predictable Reimbursement Sanford nursing director back home after an opportunity to help a hospital in Costa Rica What do malpractice payments look like in North Dakota?

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

OCTOBER 25, 2024

Million in Tucson Steward Arizona behavioral hospital gets interim manager Former AZ Department of Health employee charged in Medicaid fraud indictment Arizona hospital performs kidney transplant using robotic technology ARKANSAS NIH Director “blown away” by health care efforts in Arkansas Arkansas Gov.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

DECEMBER 1, 2023

with more than 5 Magnet designations Four more years: Anthem Blue Cross and Blue Shield, Wellstar re-up contract Hospital fails to dodge $10M malpractice verdict after attempting to pin payment on radiologist New survey reveals insight into Georgia’s maternal health crisis New chief medical officer hired for St.

Nursing Homes 40

Nursing Homes Nurses COVID-19 Ransomware 40

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ biotech mulling sweetened acquisition offer D.C. Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

OCTOBER 6, 2023

Tammany Health System create new residency program CHRISTUS nationally recognized for high-quality heart care Behind Ochsner LSU Health’s multimillion-dollar tech upgrades MAINE Millinocket hospital schedules renovation after $3.5M medical school to revamp philanthropic efforts Sage Health opening 3 central Md.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

OCTOBER 6, 2023

Tammany Health System create new residency program CHRISTUS nationally recognized for high-quality heart care Behind Ochsner LSU Health’s multimillion-dollar tech upgrades MAINE Millinocket hospital schedules renovation after $3.5M medical school to revamp philanthropic efforts Sage Health opening 3 central Md.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

DECEMBER 13, 2024

News & World Report for the Best Hospitals for Maternity Englewood Health Expands Local Availability of Specialized Medical and Surgical Expertise with the Addition of Several New Specialists Hackensack Meridian Jersey Shore University Medical Centers New $45 Million Cardiovascular Suite Opens Dec. TEXAS Bivacor to implant more U.S.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Hospitals Nurses 40

Hall Render

JUNE 7, 2024

million bird flu shots to U.S.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

JULY 22, 2022

cancer, cardio lab fraud. State settles University of Iowa medical malpractice lawsuit for $7.5 HHS orders additional 2.5 million doses of monkeypox vaccine. Supreme Court clarifies liability standard for physicians prescribing controlled substances. Telemedicine exec among 36 charged in $1.2B detected in at least 7 states.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

JUNE 30, 2023

Mary’s Hospital unit closures Two Blessing Health leaders retire on July 1 OSF: Peru hospital to be reopened in fall Expert panel examines policy opportunities at intersection of health and incarceration in Illinois Illinois health policy experts discuss Medicaid managed care and the future of dual-eligible coverage INDIANA 3 big noncompete ban (..)

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

DECEMBER 20, 2024

hospital Nemours Children’s Health plans $130 million investment at Wilmington campus New trial ordered in Temple Health’s $45M malpractice case Operating engineers union wins St. United Therapeutics ‘no longer pursuing’ nearly 350 acres in Hackett Hill area NEW JERSEY 4 N.J. to state economy, report finds N.J.s

Nursing Homes 40

Nursing Homes Nurses Hospitals Fraud 40

Hall Render

APRIL 14, 2023

But hospitals say they can’t afford to pay California hospital nurses to receive raises of up to 30% California pharmacist pleads guilty to multi-year Medicare fraud scheme Carmichael-based Eskaton pays $5.5 Where does it leave medication abortion in Pa.,

Nursing Homes 40

Nursing Homes US Department of Health and Human Services COVID-19 Nurses 40

Hall Render

OCTOBER 11, 2024

NATIONAL 92% Of U.S. Here is what it will involve. billion on hospital acquisitions Wolfson Children’s Hospital ranked among best in 4 specialties, per U.S.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

NOVEMBER 17, 2023

Million Individuals Affected by MOVEit Hack MARYLAND Adventist HealthCare, Montgomery College form partnership to address need for qualified nursing workforce Harford Memorial Hospital closing set for Feb. million patients stolen during ransomware attack MINNESOTA CFO of the Year 2023: Penny Cermak, HealthPartners Inc. Many more are waiting.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40