DSOs Beware — Here Comes the Government

The Office of the Inspector General (OIG) has continued its crackdown on DSO non-compliance. DSOs should be wary of continued scrutiny regarding DSO structures along with the heightened suspicion of fraud and abuse in the dental industry. Recently, Congress has expressed concerns regarding DSOs, which includes calling on HHS to exclude from Medicaid participation any corporate-owned dental clinics using “deceptive practices” that result in unnecessary or substandard care.

OIG’s Corporate Integrity Agreement (CIA) tend to follow similar structures which are on the rise. All DSO’s should be aware of CIA’s and how they can dramatically interfere with day to day operations. Compliance is no longer an option.

Below is a list of seven (7) items for DSOs to consider:
1. Establish effective compliance policies and procedures.
2. Designate a Compliance Officer and compliance committee.
3. Train and educate staff members regarding compliance.
4. Continually review the compliance program.
5. Report and respond to issues effectively and completely.
6. Monitor and correct any quality of care or medical necessity issues.
7. Ensure accurate billing and coding for services rendered.

Take These 5 Steps When an Employee Gets COVID-19

As the on-set of COVID-19 continues, as an employer, how are you going to handle your internal procedures if you learn that an employee has tested positive for COVID-19. Employers should act immediately to ensure the safety of the employee’s co-workers and comply with all applicable laws.

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Telepharmacy Fraud Enforcement Action Risks

The U.S. Department of Health and Human Services Office of Inspector General (HHS/OIG) recently announced five additional guilty pleas relating to a $1 billion telepharmacy fraud scheme. The health care fraud investigation consisted of personnel from HHS/OIG, the U.S. Department of Justice (DOJ), the U.S. Food and Drug Administration (FDA), the U.S. Postal Services (USPS), the Federal Bureau of Investigation (FBI), the Office of Personnel Management (OPM), and the Department of Homeland Security (DHS).

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