Compliance Connection
July 2017

Compliance Resource Center is dedicated to keeping you informed on what’s new in the healthcare compliance industry and our suite of solutions. Below you will find important updates, relevant articles, and more.

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Hotline Service Center

According to a recent CRC article, many healthcare organizations are overpaying for their hotline services, yet hotline reporting is increasing overall. CRC offers confidential and anonymous reporting through both a traditional telephone hotline service and a secure, web-based reporting service. We believe it’s important to let our clients select the type of reporting that best suits their needs and that best resonates with their employees. However, web-based reporting is quickly becoming the most convenient, and cost-effective, way for healthcare organizations to collect and address reports about potential violations.

Our online system is easy to use and guides your employees through providing the most essential information that the client may need for their investigation. We are able to track all reported issues through resolution via our secure online module, and we can instantly send our clients updated reports for download and review. Our web-based reporting system allows your employees to document any concerns in their own voice and provides the option for complete anonymity. This kind of reporting can help you reduce hotline vendor costs and may increase the amount of reports that your employees submit.

For more information about the Hotline Service Center, or to learn how you can better manage your hotline reports, please contact CRC Support at 703.683.9600, ext. 492 |

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Sanction Screening Services

The S3 Tool and CRC’s screening services are easy and efficient methods for you to regularly monitor existing sanctioned names and to check potential employee names prior to hiring them. You can avoid the risks of continuing to work with excluded individuals or entities and of asking someone with past or present illegal conduct to join your team. This solution creates a safer work environment for your employees and provides you with a reliable tool to monitor and manage any confirmed excluded individuals or entities.

View the write up about the Illinois excluded individual from the OIG investigation here.

Monthly Updates

In June 2017, CRC updated all state database names in our S3 system. Our clients will see the new names in all reports from July moving forward. The list below shows the updates for each state:

Previous S3 Source Name **Updated S3 Source Name**
Alaska Medical Assistance Excluded Provider List Alaska Medical Assistance Excluded Provider List
AL Title XIX Exclusion List Alabama Individuals Excluded From Participating in the Medicaid Program
AR Excluded Provider List Arkansas Excluded Provider List
Arizona Medicaid Excluded Providers Arizona Excluded Providers
CA Suspended and Ineligible Provider List California Medi-Cal Suspended and Ineligible Provider List
CT Administrative Actions List Connecticut Administrative Actions List
DC Excluded Parties List District of Columbia Excluded Parties List
FL Health Care Admin Public Records Florida Agency for Health Care Administration (AHCA) Public Records
Georgia OIG Exclusions List Georgia List of Excluded Individuals and Entities
HI List of Excluded Providers Hawaii Medicaid Provider Exclusion/Reinstatement List
Iowa Medicaid Provider Sanctions List Iowa Medicaid Provider Sanctions List
Idaho Medical Provider Exclusion List Idaho Medicaid Exclusion List
IL Dept HHS List of Excluded Individuals/Entities Illinois Medicaid Sanctions
IN TERMINATION OF PROVIDER PARTICIPATION IN MEDICAID AND CHIP Indiana Termination of Provider Participation in Medicaid and CHIP
KS Medicaid Termination List Kansas Medicaid Termination List
Kentucky Medicaid Excluded/Termed Provider Kentucky Medicaid Provider Termination and Exclusion List
LA Excluded Providers Louisiana State Exclusion List
Suspended or Excluded MassHealth Providers Massachusetts List of Suspended or Excluded MassHealth Providers
MD List of Excluded Individuals/Entities Maryland MMA Providers & Other Entities Sanctioned List
ME Program Integrity Excluded Providers MaineCare Monthly Provider Exclusion Report
MI List of Sanctioned Providers Michigan Medicaid Sanction Provider List
MN Excluded Providers Minnesota MHCP Exclusion Lists
Missouri Medicaid Terminated List Missouri Medicaid Terminations
MS Comprehensive Listing of Providers Mississippi Sanctioned Provider List
Montana Montana Excluded or Terminated Medicaid Providers
NC Excluded Providers North Carolina State Excluded Provider List
North Dakota Provider Exclusion List North Dakota Provider Exclusion List
NE Disciplinary Actions against Professions Nebraska Medicaid Excluded Providers
State of New Jersey Consolidated Debarment Results New Jersey Consolidated Debarment Report
Nevada Excluded/Sanctioned Providers Nevada Exclusions/Sanctions
NY Restricted or Terminated or Excluded List New York OMIG List of Restricted and Excluded Providers
OH Medicaid Provider Termination & Exclusion List Ohio Medicaid Provider Exclusion Suspension List
PA Medicheck (Precluded Providers) List Pennsylvania Medicheck (Precluded Providers) List
SC Excluded Provider List South Carolina Excluded Providers List
TN Terminated Providers List Tennessee Terminated Provider List
TX List of Excluded Individuals/Entities Texas List of Excluded Individuals/Entities Search
WA Provider Termination and Exclusion List Washington Provider Termination and Exclusion List
WV Sanctioned/Excluded Provider List West Virginia Medicaid Provider Sanctioned/Exclusion
WV Additional Exclusions West Virginia Medicaid Provider Sanctioned/Exclusion (Additional Exclusions List)
WY Provider Exclusion List Wyoming Medicaid Provider Exclusion List

The following federal and state agencies recently updated their sanction and exclusion data:

Federal Databases

  • DEA
  • NPI Registry
  • OIG Waivers

The OIG Waivers database was updated on June 29, 2017. The OFAC SDN and DEA databases were updated on June 28, 2017. The NPI Registry was updated on June 26, 2017. The GSA SAM was updated on June 21, 2017. The OIG LEIE and the DEA ACAD databases were updated on June 19, 2017.

State Databases

·         AK

·         AL

·         AR

·         CA

·         CT

·         DC

·         FL

·         GA

·         HI

·         IA

·         ID

·         IL

·         IN

·         KY

·         LA

·         MA

·         MD

·         ME

·         MI

·         MN

·         MO

·         MS

·         NC

·         ND

·         NE

·         NJ

·         NV

·         NY

·         OH

·         PA

·         SC

·         TX

·         WA

·         WV

·         WV2

·         WY

The WA and WY state databases were updated on June 30, 2017. The following state databases were updated on June 29, 2017: GA, MS, NC, NE, NV and SC. The FL, KY, OH and PA state databases were updated on June 28, 2017. The MN and MO state databases were updated on June 27, 2017. The following state databases were updated on June 26, 2017: AK, AL, AR, CA, DC, HI, IA, ID, LA, MI, TX and WV2. The following state databases were updated on June 23, 2017: IL, IN, MD, ME, ND and NY. The CT, MA and WV state databases were updated on June 22, 2017. The NJ state database was updated on June 20, 2017.

Stay aware of additional updates throughout the month by checking the What’s New” section on the S3 website.

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Compliance Survey Center

Our Compliance Culture Survey is meant to measure employees’ perceptions and attitudes of your compliance program and benchmarks the results against other healthcare providers through the Health Care Compliance Index. We use a Likert-based survey that covers multiple dimensions relating to employees’ emotional responses to your compliance program. This is beneficial because it addresses where your employees may be unsatisfied with your compliance program.

We also provide a Compliance Knowledge Survey, which we recommend our clients implement prior to the Compliance Culture Survey. To date, our Compliance Knowledge Survey has had 42,442 individual survey participants.

Both surveys are meant to improve overall compliance operations whether it is through gauging the practical effectiveness of the program, as in the Compliance Knowledge Survey, or measuring your employees’ attitudinal relationship with the program, with the Compliance Culture Survey.

To read more about the increasing success of Compliance Culture Surveys, check out this article.

For more information about our Compliance Survey Center, contact Jillian Bower at 703.535.1405 |

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Policy Resource Center

Our Policy Resource Center features a wide variety of policy and compliance-related documents that serve as a resource for you to stay up-to-date on changing compliance rules and regulations. The PRC also includes customizable templates that we can tailor to meet your requirements, giving you specifically what you need in order to best manage your compliance program.

Our document categories include:

  • Agreements and Charters
  • Anti-Kickback Statute
  • Stark Law
  • Claims Development & Submission-General Risks
  • Claims Development & Submission-Specific Risks
  • Clinical Research
  • Compliance Auditing & Monitoring Plans
  • Corporate Governance & Compliance
  • Cost Reports
  • Emergency Medical Treatment and Active Labor Act (EMTALA)
  • Facility Operations
  • Governance and Compliance
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Human Resources
  • Job Descriptions
  • Laboratory Service
  • Network & Communication
  • Physicians at Teaching Hospitals (PATH)
  • Provider Type
  • Quality of Care
  • Recovery Audit Contractor
  • Sarbanes-Oxley

To learn more about the PRC or sign up for a demonstration on how to use this solution, contact CRC today.

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Training Center

Our Compliance Training Center offers up-to-date materials to conduct comprehensive online training about your compliance program and other high-risk areas. This is an easy and efficient way for you to ensure that your employees are informed about and trained on regulatory compliance, compliance activities, and your business operations. Our solution creates a more unified work environment and minimizes the amount of HIPAA complaints in your organization.

Read this article to find out more on the OCR’s reports of growing HIPAA complaints in the compliance industry.

Schedule a training session today to refine your program’s operations and refresh your organization’s understanding of compliance.

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