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Single Specialty Ambulatory Surgery Centers Single Specialty Ambulatory Surgery Centers (ASCs) have gained significant popularity in recent years due to their focus on providing specialized surgical care in an outpatient setting. As these centers continue to evolve and adapt to changing healthcare landscapes, it is important to address some frequently asked questions (FAQs) surrounding their […]
Skilled Nursing Facility and Nursing Home Annual Work Plan The OIG’s 2017 Annual Work Plan identified a few new areas of focus relating to nursing homes and skilled nursing facilities. Nursing home compliance officers should consider these newly identified issues when developing their annual compliance work plan. Investigation of Serious Nursing Home Conditions The Work […]
General Priorities in the Yates Memorandum The Yates Memo prioritizes the manner in which Government civil and criminal law enforcement investigations are conducted. It begins by proclaiming that “One of the most effective ways to combat corporate misconduct is by seeking accountability from the individuals who perpetrated the wrongdoing . . . [accountability] it deters […]
Federal False Claims Act – Lincoln’s Law Applied to Health Care When Congress originally passed the False Claims Act (31 USC §§ 3729-3733), no one had the health care system in mind. The False Claims Act was also commonly referred to as the “Lincoln Law”. The original law was focused on unscrupulous vendors who provided […]
LIST OF COMPLIANCE-RELATED POLICIES AND PROCEDURES PROCESS POLICIES AND PROCEDURES Compliance Program Resolutions Appointment Of Compliance Officer Compliance Plan Document – General Code Of Conduct Statement Of CEO On Compliance Statement Of Board Of Directors Compliance Committee Charter Uniform Compliance Definitions Compliance Plan Elements Compliance Oversight Committee Policy Compliance Office Staff Yearly Compliance Program Review […]
Data Mining Used to Identify Practice Outliers A Note From the OIG Presentation at the HCCA Compliance Institute The federal government is actively using data to identify providers who perform outlier billing. If your billing patterns reflect a pattern that is greatly outside of norms, you should be prepared to defend the deviation from the […]