The Office of Inspector General maintains a List of Excluded Individuals/Entities (LEIE) database, which is updated on a monthly basis. Medical staff stakeholders can search the database to identify entities and individuals who are excluded from Medicare, Medicaid, and other federal healthcare...
This week, CRC Daily covers credentialing, which is among the many duties that require effective collaboration between medical staff leaders and MSPs. It is a mistake to assume that a practitioner who has been on the medical staff for a while and has gone through the application process...
Your organization must decide if it will include co-terminus language in the employment agreement regarding employment and privileges. This means that if the physician is terminated, he or she automatically loses medical staff membership/clinical privileges. If there is no co-terminus language,...
Your clinical privilege forms need to be reviewed on a regular basis to ensure they reflect up-to-date criteria requirements and standards for the procedure or specialty in question. For example, a procedure that used to be considered a special, noncore privilege when you developed your forms...
It's impossible to calculate the amount of healthcare fraud that exists, as much of it slips under the radar. However, healthcare fraud poses a serious problem, putting the health and welfare of beneficiaries at risk while costing taxpayers billions of dollars.
