decisionhealth Newsletters, Part B News - 2023 Issue 5 (May)
NPPs get hired without licenses, despite exclusion; keep your guard up
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Article Overview
This practice management article examines hiring and credentialing risks for clinical staff, especially nonphysician practitioners, through the lens of a fraud case involving an improperly credentialed physician assistant. It covers general compliance checks such as license verification, exclusion screening, background review, and state-level licensure considerations, and it is relevant to practice managers, compliance staff, and healthcare administrators.
Why This Topic Matters
Hiring or retaining unqualified or excluded clinical staff can expose a practice to fraud, repayment, legal, and patient-safety risks. The article helps readers understand the importance of ongoing credential verification and compliance screening.
Article Sections
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Practice management
Introduces the compliance and hiring risks associated with clinical staffing. It frames the broader administrative concerns raised by the case example.
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Don’t trust, verify
Discusses the need for credential verification and ongoing oversight during hiring and employment. It also addresses the pressures that can make vetting more difficult in today’s workforce environment.
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Not just the license
Covers additional screening and compliance checks beyond basic licensure, including background review, exclusion screening, and state-level practice requirements.
What You Will Learn
- Why credential and license verification matters in clinical hiring
- What broader compliance checks are commonly discussed for healthcare personnel
- How workforce shortages can increase hiring and oversight risks
- Why exclusion screening and background review are important in practice operations
- How state-level licensure and collaboration requirements may affect clinical staffing
Who Should Read This
- Practice managers
- Compliance officers
- Healthcare administrators
- Billing staff
- Physician practices
- Nursing leadership
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