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Hugh’s Credentialing Digest – Credentials Committee Organization and Management

Recently, while watching a credentials committee in action, I was struck by the lack of organization and committee management evident in the room. Below are a few of my observations: • The chair arrived late and immediately began a conversation with another member about a patient. • Of the eight appointed members, only four were…

Electronic Health Records Vendor to Pay $155 Million to Settle False Claims Act Allegations

One of the nation’s largest vendors of electronic health records software, eClinicalWorks (ECW), and certain of its employees will pay a total of $155 million to resolve a False Claims Act lawsuit alleging that ECW misrepresented the capabilities of its software, the Justice Department announced. The settlement also resolves allegations that ECW paid kickbacks to…

Hugh’s Credentialing Digest—Embracing Change, Produced by Hugh Greeley

Inspiring Physicians to Embrace the Change that Defines Success in Health Care is the topic for Hugh’s Credentialing Digest, Produced by Hugh Greeley “The greatest barrier to a paradigm shift is the reality and incredible inertia of paradigm paralysis. A paradigm paralysis can be defined as the inability or refusal to see beyond current models…

Houston-Area Psychiatrist Convicted of Health Care Fraud for Role in $158 Million Medicare Fraud Scheme

May 30, 2017 – A federal jury convicted a Houston-area psychiatrist today for his role in a $158 million Medicare fraud scheme. The OIG searchable database on exclusions shows no records on Riaz Mazcuri giving him opportunity to continue to defraud Medicare, practice medicine and take referrals since any individual or entity searching on behalf…

Hugh Greeley Hosts Webinar on Credentialing Locum Tenens

Verisys and the American Hospital Association (AHA) is co-hosting a webinar focused on credentialing for locum tenens as well as the practice of telehealth care. This new paradigm of practicing medicine creates a new set of challenges for medical staff professionals and credentialing verification organizations. Talent sharing through locum tenens and telehealth care is the…

Final Group Of Physicians And Owner Of Medical Practice Plead Guilty In Medical Kickback Scheme

Pam Gardner, 55, of Springfield, Tennessee, pleaded guilty yesterday, to conspiracy to solicit and receive cash kickbacks in exchange for making patient referrals, announced Jack Smith, Acting United States Attorney for the Middle District of Tennessee. During a hearing before U.S. District Court Judge Sean Cox, sitting by designation, Gardner admitted that, as the owner…

Health Care Data Security – 10-Point Checklist

When choosing a partner for healthcare exclusion screening and monitoring or credentialing verification services, it is important to compare all healthcare credentialing partners against these top 10 data security measurements to protect your organization from financial loss, regulatory and reputational damage through non-compliance. With Verisys, you can put your worries at ease knowing that your…

Alexander Burman Sentenced To 10 Years In Prison For $26 Million Scheme To Defraud Medicare And Medicaid

May 16, 2017 – Defendant Established Six Clinics in Brooklyn that Paid Elderly People to Pose as Patients, and Billed Medicare and Medicaid For Unnecessary and Non-Existent Medical Care and Equipment. Joon H. Kim, the Acting United States Attorney for the Southern District of New York, announced that ALEKSANDR BURMAN, a/k/a “Alexander Burman,” was sentenced today…

Medical Staff Bylaws – Prevention is the Cure

Hugh’s Credentialing Digest – Medical Staff Tips Over past decades, often medical staffs have advanced their procedures and regulations only at the prodding of accreditation agencies or when required by law to do so. Consider the long-forgotten medical staff controversy about adding a clause to the bylaws eliminating discrimination based upon race, religion, creed, color…

HHS OIG Release Updated LEIE and CIA Lists

The Department of Health and Human Services Office of Inspector General (HHS OIG) released updated LEIE Database to include exclusions, reinstatements, profile corrections plus the monthly supplement archive. In addition, HHS OIG has released an updated Corporate Integrity Agreement List with a current total of some 364 records. Call Verisys to handle your screening, verifications…