What is the New Nursing Facility ICPG?

Just last month the Office of the Inspector General (OIG) put out an Industry Segment-Specific Compliance Program Guidance for Skilled Nursing Facilities and Nursing Facilities (Nursing Facility ICPG). Since 1998, the OIG has been issuing voluntary Compliance Program Guidance documents (CPGs) directed at various segments of the health care industry. At the center of this CPG modernization effort is the OIG’s General Compliance Program Guidance (GCPG), a reference guide for the health care compliance community…

Not Conducting Exclusion Checks – Is it Worth the Risk?

Is your organization conducting regular exclusion checks for your vendors and employees? With the repercussions of contracting or employing an excluded individual or vendor, exclusion checks should be an important part of any organization’s compliance program. Organizations can receive a penalty of up to $20,000 for each billable service conducted after February 9, 2018, and up to $10,000 for any billed services before that date. Those fines can be costly for any organization employing or…

10 Factors that Could Trigger an Audit of Your Medical Records

With the ever-increasing litigious environment and mandatory Congressional oversight of commercial and government payers, physician supporting documentation should emphasize and include the type of service(s) provided, the time involved, special technology and equipment used, as well as any other complications encountered.Furthermore, because the government and insurance carriers routinely perform audits as mandated through the Fraud, Waste and Abuse program, it’s important for providers to be aware of problems that could cause them to come under…