News & Analysis as of

HHS to Audit Hospital Reporting of GPO Payments: GAO Report Suggests Further Scrutiny of GPO Shareback with Hospitals

On November 24, 2014, the Government Accountability Office (“GAO”) published a report examining the contracting practices and funding structures of health care group purchasing organizations (“GPOs”) and their potential...more

The OIG Work Plan: Does OIG Always Know Best?

Provider Compliance Departments routinely set audit priorities based, in part, on OIG’s Work Plan, but what should a provider do if it disagrees with a position that the OIG takes? Providers should be prepared to defend their...more

OIG updated work plan includes evaluations of CFPB enforcement-related processes and procedures

The Office of Inspector General’s (OIG) work plan, updated as of November 7, 2014, indicates that the OIG’s ongoing projects include audits of the CFPB’s information security program, pay and compensation program,...more

OIG 2015 Plan Focuses on ICE’s Business Selection Process for I-9 Investigation

As part of its 2015 fiscal year Annual Performance Plan published on October 1, 2014, the Department of Homeland Security’s (DHS) Office of Inspector General (OIG) will review the approach of Immigration and Customs...more

Blog: HHS OIG Hands Out 2015 Work Plan For Halloween

On Friday October 31, 2014, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) released its annual “Work Plan” for fiscal year 2015. The Work Plan is a compilation of the OIG’s plans for...more

OIG identifies five major CFPB management challenges

The joint Federal Reserve/CFPB Office of the Inspector General (OIG) recently issued its first listing of “major management challenges” facing the CFPB. These challenges represent what the OIG believes to be “the areas that,...more

HUD OIG report critical of asset repositioning fee calculations

HUD’s Office of Inspector General (OIG) issued an audit of HUD last week pertaining to awards of asset repositioning fees (ARF), the funds that public housing authorities (PHAs) may receive in connection with demolishing or...more

Client Alert - The Rules of the Game Change As ICE Targets Employers

The year 2009 marked a dramatic change in Immigration and Customs Enforcement’s (ICE) workforce enforcement strategy. Up until 2008, ICE focused its enforcement efforts almost exclusively on illegal workers. For instance, ICE...more

AHA Renews Complaints about OIG Hospital Compliance Reviews

The American Hospital Association (AHA) has renewed its complaints about OIG “hospital compliance reviews.” Last Thursday AHA Executive Vice President Rick Pollack sent a letter to Health & Human Services Secretary Burwell...more

USCIS Rolls Out Full-Scale Implementation of L-1 Site Visit Program: Employers of L-1 Transferees Should Now Set up Processes to...

U.S. Citizenship and Immigration Services’ (USCIS) Fraud Detection and National Security (FDNS) Directorate has recently begun implementation of an L-1 site inspection program in response to an August 2013 report released by...more

OIG updated work plan adds focus to information security, compensation, and distribution of civil penalty funds

The most notable items added by the Office of Inspector General (OIG) to its work plan, updated as of July 7, 2014, are audits of the CFPB’s information security program, pay and compensation program, and distribution of...more

OIG audit criticizes public housing asset management

A new HUD Office of Inspector General (OIG) audit published last week levied intense criticism at HUD’s implementation of public housing asset management. Focusing on HUD’s methodology and monitoring of asset management and...more

Proposed Expansion of OIG’s Exclusion Authority

In May, the Office of Inspector General of the Department of Health and Human Services (OIG) proposed a new rule (Rule) that would implement changes included in the ACA. The Rule would expand OIG’s authority to exclude...more

FIO Focus, Issue No. 52

Treasury's Inspector General Releases Audit Report for the Federal Insurance Office - On May 14, 2014, the Office of the Inspector General (OIG) of the U.S. Department of the Treasury released its audit report of the...more

Health Headlines: Also in the News - May 2014

OIG Reports Jurisdiction H Contractors Made $3.3 Million in Overpayments for Outpatient Drugs – According to a recent OIG report, the Medicare Contractors for Jurisdiction H overpaid providers approximately $3.3...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

OIG Releases Report on EHR Fraud Controls

On December 11, 2013, the HHS Office of Inspector General (OIG) released a report examining provider use of certain fraud controls in certified electronic health record (EHR) technology. OIG’s survey of 864 hospitals found...more

OIG issues report on CFPB information security system

The Bureau’s Office of Inspector General (OIG) (which it shares with the Fed) recently issued its 2013 report card on the CFPB’s information security system. While the OIG states in the audit report that the CFPB has made...more

OIG and MA Plan Sponsor Settle Allegations of Altering Records Submitted During Audit

Bravo Health Pennsylvania, Inc. (Bravo), a Medicare Advantage Plan Sponsor and subsidiary of Cigna Corporation, agreed to pay $225,000 to the Government for allegedly misrepresenting or falsifying information furnished to the...more

Federal Government Aggressively Pursuing Health Care Fraud

Proactive self-audits help providers identify potential problems - The Federal Government is using every tool available to fight health care fraud and recover overpayments from health care providers. According to the...more

2013 Healthcare Fraud and Abuse Bootcamp Webinar Series, Part V: Compliance

Bill Mathias of Ober|Kaler's Health Law Group presented on compliance as a part of the 2013 Healthcare Fraud and Abuse Bootcamp Webinar Series sponsored by the American Health Lawyers Association. This webinar...more

BRG GovCon Research Report - January - March 2013

In This Issue: - GSA and VA Schedule Matters - Office of Inspector General Reports - Pertinent Government Accountability Office (GAO) Audit Reports - OMB Proposed Guidance - Key Federal Acquisition...more

OIG Reports that Millions of Medicaid Overpayments Remain Uncollected

On February 19, 2013, the OIG published a report detailing the collection status of Medicaid overpayments. The Secretary of HHS requires CMS to collect overpayments, defined as “the amount paid by a Medicaid agency to a...more

Dealing with RAC Audits and Denials: How Healthcare Providers Can Manage Medicare Recovery Efforts

Executive Summary: Medicare RAC (Recovery Audit Contractor) audits are becoming increasingly aggressive, creating delays in payment for healthcare providers. Certain strategies can help mitigate delays caused by RAC audits...more

OIG Concludes in Nationwide Review of Drug That Herceptin Has Often Been Overbilled

The HHS OIG has conducted a nationwide audit of the use and reimbursement of Herceptin (also known as trastuzumab), a Medicare-covered drug used to treat metastatic breast cancer, and has concluded in three audits released in...more

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