Office of the Inspector General

News & Analysis as of

OIG Interim Evaluation of ACA LTC Employee Background Check Grant Program

The HHS Office of Inspector General (OIG) has issued an interim evaluation report on an Affordable Care Act (ACA) program that provides grants to states to implement background check programs for prospective long-term care...more

Drug Manufacturer Discount Cards: Accept With Caution

Pharmaceutical manufacturer discount card usage by government program beneficiaries has been an active area for government action in recent years. In a September 2014 Special Advisory Bulletin, the U.S. Department of Health...more

Update on Significant DOT, FAA and Other Federal Agencies’ Aviation-Related Regulatory Actions - February 2016

This edition of the Cozen O’Connor Aviation Regulatory Update includes the recently signed U.S.-Mexico bilateral agreement that liberalizes air services between the two countries, new Cuba-related regulations loosening...more

Increased Scrutiny of Drug Pricing What Should Pharmaceutical Companies Know

As U.S. spending on pharmaceuticals continues to rise, reaching $373.9 billion in 2014, government scrutiny of drug pricing practices has increased in response. Early last year, the U.S. Department of Health and Human...more

Recent Corporate Integrity Agreements Highlight HHS OIG’s Compliance Program Priorities

Corporate Integrity Agreements (CIAs) are among the most important tools in the U.S. Department of Health and Human Services Office of Inspector General’s (OIG) toolbox for promoting compliance in the health care industry....more

DMEPOS Prior Authorization Rules Expand

On December 30, 2015, CMS published a final rule entitled: "Medicare Program; Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies," implementing Section 1834(a)(15) of the...more

Potential Part B Drug Payment Cuts for 340B Hospitals

The influential Medicare Payment Advisory Commission (MedPAC) has voted to recommend to Congress in its March report that Medicare Part B drug payment rates for 340B drugs be reduced by 10 percent for hospitals participating...more

Whose Turn To Pay? New OIG Opinion Provides Clarity Regarding Payment of Radiology Transcription Fees

A new OIG opinion clarifies that providers are free to determine who will pay the transcription fees when separate parties perform the professional and technical components of a radiology exam. ...more

Solicitation of New Safe Harbors and Special Fraud Alerts

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently announced its annual solicitation of proposals and recommendations for developing new, and modifying existing, safe harbor provisions...more

Manatt on Health Reform: Weekly Highlights - January 2016

Louisiana's Governor signs an executive order on his first day in office to expand Medicaid; Kentucky's Governor opts to replace, rather than repeal, its Medicaid expansion program; and New York and Missouri make it easier...more

Washington Healthcare Update

This Week: The Senate and House pass legislation to repeal the Affordable Care Act but without enough votes to override a potential veto... However, this is the first time repeal legislation makes it to the President’s...more

OIG Issues Alert on Physician Compensation and Medical Director Arrangements

On June 9, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Fraud Alert entitled "Physician Compensation Arrangements May Result in Significant Liability" (OIG Alert). The OIG...more

2016 Trends #3: Board Expectations for Ethics & Compliance Oversight Get More Specific, Uniform and Comprehensive

According to the U.S. Sentencing Guidelines for Organizations—and similar provisions found in other guidelines worldwide—an organization’s governing body is responsible to “exercise reasonable oversight with respect to the...more

Also In The News - Health Headlines - January 2016

OIG Solicits Proposals for New or Modified Safe Harbor Provisions and Additional Special Fraud Alerts - As required by Section 205 of the Health Insurance Portability and Accountability Act of 1996, the OIG has published...more

Federal Spotlight Continues to Shine on Physician-Owned Distributorships

A recent Senate Finance Committee hearing investigated the effects of physician-owned distributorships (“PODs”) on costs of care and patient safety, suggesting that the momentum for greater oversight of such business...more

Laboratories – 2015 Year in Review [VIDEO]

Over the past year, significant regulatory changes began to take shape that will have lasting effects on the laboratory industry for years to come. After publishing draft guidance regarding the regulation of laboratory...more

HHS OIG Invites Suggestions for New Fraud Alerts, Anti-Kickback Safe Harbors

On December 23, 2015, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) published its annual notice soliciting recommendations for new or modified, safe harbor provisions under the...more

Health Update - December 2015

Lessons from Hawaii's Trailblazing ACA 1332 Waiver Proposal - Editor's Note: On September 9, Hawaii became the first state to post a draft 1332 waiver proposal for public comment. While Hawaii's proposal focuses on the...more

Federal Government Continues to Bring Actions Against Pharmaceutical and Medical Device Companies and Individuals for Alleged...

The Office of Inspector General (OIG) for the Department of Health and Human Services recently released its Semiannual Report to Congress. Through the first three quarters of 2015, OIG announced recoveries of $3.35 billion...more

OIG Tightens Requirements of Prior Favorable Advisory Opinion on Charity Patient Assistance Program for Cancer Drugs

On December 7, 2015, OIG posted a modification adding additional strictures to a prior favorable Advisory Opinion (No. 07-11) regarding a charity’s operation of a patient assistance program (PAP) to provide financial...more

2015 Health Care Year in Review

In 2015, ICD-10 finally became a reality, and the dire predictions of problems seem to be wrong. Providers now have codes to describe just about every conceivable (and a few simply bizarre) medical occurrences. If a patient...more

2016 Will Be the Year of Telemedicine and ACOs

If 2015 was the year that brought telemedicine directly to consumers, 2016 will be the year of telemedicine and Accountable Care Organizations (ACOs). ACOs are expected to increase the use of telemedicine technologies as a...more

DoD Inspector General Publishes Annual Oversight Plan

On December 10, 2015, the Office of the Inspector General (OIG) for the Department of Defense published its Oversight Plan for Fiscal Year 2016. While the Defense OIG has published an annual audit plan in past years, this is...more

Highlights From The 2016 OIG Work Plan

The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) has released its Work Plan for Fiscal Year 2016. The annual work plan can provide valuable insights into the OIG’s planned areas of...more

OIG Issues Fall 2015 Semiannual Report to Congress

The HHS Office of Inspector General (OIG) has issued its Semiannual Report to Congress covering April 1 – September 30, 2015. The report summarizes significant OIG audits, investigations, and enforcement activities during...more

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