Medicare Compliance & Reimbursement

Not only do you need to check the HHS Office of Inspector General (OIG’s) searchable database of individuals excluded from federal healthcare programs, but you also need to do an educational background check on your clinical staff, too, a recent enforcement action reminds.

Scoop: Last month, OIG embarked on a massive enforcement action focusing on a fraud scheme that sold fake and fraudulent nursing degrees, diplomas, and transcripts from accredited nursing schools in Florida to individuals across a multitude of states. “The individuals who acquired the bogus nursing credentials used them to qualify to sit for the national nursing board exam. Upon successful completion of the board exam, the nursing applicants became eligible to obtain licensure in various states to work as an RN or a LPN/VN,” OIG explains in an alert on the case.

After getting their licenses, the individuals entered the healthcare workforce. More than 7,600 fake nursing diplomas and transcripts were sold, OIG says.

Twenty-five people were charged in the case. Each defendant could see upward of 20 years in prison, a Department of Justice (DOJ) release says.

“Not only is this a public safety concern, it also tarnishes the reputation of nurses who actually complete the demanding clinical and course work required to obtain their professional licenses and employment,” said U.S. Attorney for the Southern District of Florida Markenzy Lapointe, in a DOJ release. “A fraud scheme like this erodes public trust in our health care system,” Lapointe added.

Review the DOJ release at www.justice.gov/usao-sdfl/pr/ fraudulent-nursing-diploma-scheme-leads-federal-charges-against-25-defendants.