Healthicity Blog

We hear a lot about fraud and abuse involving the Medicare program, and rightfully so. But because Medicaid programs are state-run, we may not hear of Medicaid issues unless they are in the news, in the state we live or work in.

A few months ago, we conducted a survey of 1,200 healthcare executives. Some of the challenges reflected in the survey might be the very things that are currently keeping you up at night.

If you’re anything like me, you are really looking forward to the HCCA’s annual Compliance Institute this month in National Harbor, MD. In addition to seeing colleagues and networking, it’s a great place to hear multiple perspectives on healthcare compliance.

President Trump’s words might lead us to believe we’re heading towards an “anti-regulation” future. But I think the foundations of compliance programs will remain intact.

The DOJ recently published this document, which provides additional insight into their practices of evaluating compliance programs.

Back in the 1980’s, Larry Plutko started his career in Healthcare and by the 90’s found himself fascinated by compliance. In 2008, he accepted a position of compliance officer in Austin, Texas, where he became an important career mentor to me.

When we hear of doctors, hospitals and other healthcare providers settling False Claims Act allegations with the government, we frequently learn that the accusations were first raised by a current or former employee or another healthcare provider such as a physician.

Most of us by now have heard of the Yates’ Memo that directs the Department of Justice attorneys to hold individuals accountable for inappropriate actions associated with corporate wrongdoing. Since the memo, there’s been an increase of corporate accountability in the headlines, which demonstrates...