Month: January 2020

OIG Compliance is the Key

When a healthcare organization is found to not be in compliance with laws or regulations, corporate integrity agreements (“CIA”) and civil monetary penalties (“CMP”) may be the unintended consequences.

Beginning in September 1999, the United States Department of Health and Human Services (“HHS”) and the Office of Inspector General (“OIG”) embarked on an initiative to prevent the submission of erroneous claims and combat fraud and abuse in the Federal health care programs through voluntary compliance efforts.  Submitting a false claim, or causing a false claim to be submitted, to a Federal health care program may subject the individual, the entity, or both to criminal prosecution, civil liability (including treble damages and penalties) under the False Claims Act, and exclusion from participation in Federal health care programs.(1)  

The OIG has the authority to exclude individuals and entities from Federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.  Those that are excluded can receive no payment from Federal healthcare programs for any items or services they furnish, order, or prescribe.  This includes those that provide health benefits funded directly or indirectly by the United States (other than the Federal Employees Health Benefits Plan).

The OIG maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (“LEIE”).  Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties (“CMP”).  To avoid CMP liability, health care entities should routinely check the list to ensure that new hires and current employees are not on it.(2)

References:

  1. https://oig.hhs.gov/compliance/compliance-guidance/docs/complianceguidance/nhg_fr.pdf
  2. https://oig.hhs.gov/exclusions/index.asp

Happy New Year!

The new year is typically a time when we make resolutions to improve or maintain positive habits. Whether it’s simply to be a little kinder, or to learn a new skill, resolutions are a great way to take that first step into something better for yourself, and in some cases, your business. 

TyphoonDATA has a few resolutions this year. The first is to continuously improve our processes in day to day operations. The second is to add to our repertoire of automated sources. Finally, our third resolution is to give back to the community in valuable ways.

When you think about how a business should be run we often turn to numbers and statistics. Here at Typhoon, we think above and beyond that. Though we do value numbers and statistics. We also value job satisfaction, communication, and detail-oriented work. Everyone on our team has an important role to play. To improve day to day operations, we encourage our team to share ways in which our processes could be simplified or elevated.  

Automation makes life easy for our customers and for ourselves. It shoulders tasks that are more susceptible to human error. So improving current automation and adding to what we have is a no-brainer. We’ve added a new employee to our technology team late last year, and we have several initiatives to improve our automation and elevate our platform to the next level. 

Giving back to the community is a fairly new initiative for us. We believe acts of kindness not only help others but add to the culture of our company. We ended last year by volunteering at a local nursing home. This brought us together as a team and brought us so much joy. So this year, we’re planning and executing many more service projects all around our community in Orem, Utah.

Happy New Year from TyphoonDATA! We wish you the best in all your resolutions.