Office of the Inspector General

News & Analysis as of

Premium Credits Offered to Medigap Policyholders Okayed by OIG

The OIG has approved a licensed insurance broker’s proposal to establish a preferred hospital network as part of Medicare Supplemental Health Insurance policies (Medigap) and related premium credit offered to policy holders....more

OIG Revisits Clinical Laboratory Electronic Data Transmission Fees

Prior Opinion Rescinded and Negative Opinion Issued - The Office of Inspector General (OIG) recently issued a negative advisory opinion about an arrangement that offered relief of a $1 electronic data transmission fee...more

OIG Reports Limited Compliance with Face-to-Face Certification Requirement for Home Health

The OIG recently released a report summarizing the details of its study regarding compliance with the requirement that physicians (or certain practitioners working with them) who certify beneficiaries as eligible for Medicare...more

OIG Recommends Reduction in Hospital Outpatient Rates for Certain Procedures that Can Be Performed in ASCs

On April 16, 2014, the OIG released a report concluding that between CYs 2007 through 2011, Medicare has saved nearly $7 billion by covering surgical procedures in ASCs. In addition to the savings that would continue to...more

Health Law Wire: $85 Million settlement for first half of Halifax Qui Tam case - OIG Dan Levinson says Management failed to listen...

One of the largest settlements, if approved by the Court, is a result of compensation and incentive programs to physicians who were “employed” at Halifax Hospital in Daytona Beach, Florida. The Halifax lawsuit was filed in...more

Emerging EHR Risks: When Documentation May Not Be Enough (or Too Much)

Today’s Electronic Health Record (EHR) technologies feature many tools that help providers practice more efficiently and allow them to spend more time caring for patients. However, the federal government recently has posted...more

Healthcare IT News: OIG Does An About-Face On Referral Service Pricing

The Department of Health and Human Services Office of Inspector General (OIG) recently terminated a favorable 2011 advisory opinion regarding a healthcare IT company's "per-click" pricing model for its provider referral...more

OIG Report Praises SEC Whistleblower Program

The internal watchdog for federal government agencies, including the SEC, is the Office of the Inspector General (“OIG”), which conducts audits and investigations of the SEC to “promote integrity, economy, efficiency, and...more

OIG Issues Report on Limited Compliance with Medicare’s Face-to-Face Requirement for Home Health Services

On April 9, 2014, the US Department of Health and Human Services Office of the Inspector General’s (OIG) Office of Evaluation and Inspections (OEI) issued a report (OEI-01-12-00390) entitled “Limited Compliance With...more

OIG Finds Deficiencies In CFPB Supervisory Activities

The Office of Inspector General of the Board of Governors of the Federal Reserve System conducted an initial evaluation to assess the operational efficiency and effectiveness of the Consumer Financial Protection Bureau’s...more

Federal Reserve OIG Criticizes CFPB’s Supervision Program

On April 1, the Federal Reserve Board’s Office of Inspector General (OIG), which also is responsible for auditing the CFPB, issued a report that is critical of the CFPB’s supervisory activities and recommends that the CFPB...more

Recent FCA Decision Has Important Implications for Contractor Disclosures to the Government

A recent decision from the U.S. District Court for the Eastern District of Virginia has important implications for government contractors that make mandatory disclosures of improper conduct to the U.S. Government. In U.S. ex...more

Summary of Clinical Laboratory Fee Schedule Reform Provisions in the Protecting Access to Medicare Act of 2014

On April 1, the Protecting Access to Medicare Act of 2014 was enacted into law (Pub. L. 113-93). Section 216, entitled Improving Medicare Policies for Clinical Diagnostic Laboratory Tests, modernizes the Medicare payment...more

OIG finds CFPB’s supervision program needs improvement

Earlier this week, the results of an evaluation of the CFPB’s supervision program conducted by the Office of Inspector General (OIG) that the CFPB shares with the Fed were released in a report entitled “The CFPB Can Improve...more

OIG Issues Compendium of Unimplemented Priority Recommendations

On March 18, 2014, the OIG released its Compendium of Priority Recommendations (Compendium), which lists 25 broad “Priority Recommendations” for achieving “cost savings, improve program management, and ensure quality of care...more

DOJ OIG Report Critical Of Mortgage Fraud Enforcement Programs

On March 13, the DOJ Office of Inspector General (OIG) issued a report on its audit of the DOJ’s efforts between 2009 and 2011 to pursue alleged mortgage fraud. Of particular note, the report reveals for the first time...more

The 2014 OIG Work Plan: Select Provisions Applicable to Physician Practices

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently issued its 2014 Work Plan outlining its intended review activities of HHS Programs for 2014. This article summarizes certain...more

Health Care Update

In This Issue: Implementation of the Affordable Care Act; Other Congressional and State Initiatives; Other Health Care News; and Upcoming Hearings and Markups. Excerpt from Implementation of the Affordable Care...more

OIG 2014 Work Plan – Hospice

This article represents another installment of a series of articles that will outline the OIG’s activities, as discussed in the 2014 work plan, for a specific industry sector – hospice. For 2014, the OIG’s activities...more

OIG 2014 Work Plan – Skilled Nursing Facilities

Recently, the Department of Health and Human Services Office of the Inspector General (the “OIG”) released its work plan for 2014. The work plan provides stakeholders in the health care industry with a broad overview of the...more

OIG Releases Report on Medicaid Fraud Control Units

The Department of Health and Human Services (HHS) Office of Inspector General (HHS-OIG) has released its Fiscal Year (FY) 2013 Annual Report (Report) on the performance of the Medicaid Fraud Control Units (MFCU)...more

Halifax Settles Stark Damages for $85 Million

Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively, “Halifax”) have agreed to pay $85 million to settle allegations that Halifax compensated a group of physicians in a manner not permitted by the Stark...more

Script Newsletter: March 2014

In this issue: - A Look Behind the OIG’s Work Plan - Do You Need an Estate Plan? - Same-Gender Marriage Implications for Employee Benefit Plans - New Child Abuse Reporting Law Gets Tough -...more

OIG updated work plan includes review of CFPB headquarters renovation

Since issuing its work plan updated as of January 21, 2014, the only new notable item added by the by the Office of Inspector General (OIG) to its work plan updated as of March 3, 2014 is an evaluation of the CFPB’s...more

Blow Your Green Whistle to Protect the Environment

The Office of Inspector General is an independent office within the U.S. Environmental Protection Agency (EPA) that assists the agency in accomplishing its goals more efficiently. OIG conducts audits, investigations and...more

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