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In today's business environment compliance can be a difficult and expensive task. Even the most innocent of conversations with a physician may be misconstrued and viewed as audit exceptions.
To protect your organization against expensive fines, you must ensure that every employee who interacts with physicians understands exactly who those physicians are and their roles in treating the indications for your products.
Validation of physician specialties in your customer universe is the first step. AdvantageMS can analyze your call file and identify potential audit exceptions in advance of problems and provide your organization the opportunity to correct problems before they occur. In addition to specialty validation, AdvantageMS provides state license and DEA license updates as well as early warning reports on physician adverse actions.
Physicians Background Check
- LEIE – OIG: Fraud and controlled substance findings (approximately 400 adds and deletes/month)
- FDA
- Debarment: Controlled substance findings (approximately 2-3 new adds/year)
- Warning Letters: Protocol deviation warnings (approximately 8-10 new adds/month)
- State Action Notifications: Early warning flags that an investigation has been initiated (approximately 125 new adds/month)
- License History
- EPLS : Not included in automated process, only considered a requirement for Medicare/Medicaid contracts
The complete history of adverse action early warnings provided by the state medical boards is reviewed. Early warnings are an indicator of historical investigations and act as a red flag.
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Comprehensive list of blacklisted providers based on government sources (FDA, OIG/DHHS and GSA) includes:
- Healthcare and non-healthcare fraud
- Failure to participate in an investigation
- Fraud, kickbacks or other prohibited activities
- Failure to take corrective action on a finding
- Convictions related to controlled substances
Aggregate Spend Compliance
An ever-increasing number of states and the federal government have existing or pending regulations for the collecting, managing and reporting of spend. With rules that vary by minimum disclosure amounts, deadlines, and penalties, aggregate spend reporting can present significant operational challenges.
The data compliance services and expertise at AdvantageMS extend to helping life sciences organizations develop and support an aggregate spend compliance solution that is based on accurate and timely data. From validating the incoming spend data from disparate sources, to improving data quality, to data warehousing and reporting, AdvantageMS can help you create a single, validated view of the customer to help ensure compliance with the Physician Payments Sunshine Act.
PDMA Compliance
Prescription Drug Marketing Act violations come with significant fines and repercussions. Prescription drug sample accountability starts with accurate data. Timely, accurate state license data is a core offering from AdvantageMS, now available through batch file processing and the Storefront AdvantageMS web portal.
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