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Office of the Inspector General Inpatient Prospective Payment System (IPPS)

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | May 2022 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights notable enforcement activity between April 21 and May 20, 2022, including a telemedicine case involving $64 million in false and fraudulent claims. We also...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021

Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more

Foley & Lardner LLP

COVID-19: OIG Announces Review of Hospital Payment Increase

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The Office of Inspector General (OIG) for the Department of Health and Human Services recently announced a new addition to its work plan: auditing whether payments made by Medicare for COVID-19 inpatient discharges billed by...more

Alston & Bird

CMS and OIG Release Proposed Rules on Stark Law and Anti-Kickback Statute Reforms

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The Department of Health and Human Services is seeking comments on proposed rules to implement part of its Regulatory Sprint to Coordinated Care....more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 28, Number 40. News Briefs - November 2019 #2

Report on Medicare Compliance Volume 28, Number 40. (November 11, 2019) - - In a new Medicare compliance review, the HHS Office of Inspector General (OIG) said Angels Care Home Health in Salina, Kansas, didn’t comply with...more

King & Spalding

OIG Report Identifies Significant Vulnerabilities in the Hospital Wage Index System

King & Spalding on

In OIG Report No. A-01-17-00500 (the OIG Report), OIG allegedly identifies “significant vulnerabilities” in the wage index system that result in inappropriately-adjusted Medicare payments. The OIG Report recommends several...more

Alston & Bird

Alston & Bird Healthcare Week in Review

Alston & Bird on

Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Alston & Bird

Alston & Bird Healthcare Week In Review

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I. Regulations, Notices, & Guidance - On February 12, 2018, the Food and Drug Administration (FDA) issued a guidance entitled, Bacillus Calmette-Guérin-Unresponsive Nonmuscle Invasive Bladder Cancer: Developing Drugs and...more

King & Spalding

OIG Initiates Monthly Updates to its Work Plan and Adds New Items

King & Spalding on

The HHS Office of Inspector General (OIG) recently announced that, effective June 15, 2017, the agency will update its Work Plan website monthly instead of only once or twice per year. In developing its Work Plan, OIG...more

King & Spalding

HHS OIG Issues Report on Medicare’s 2-Midnight Rule

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On December 19, 2016, the HHS OIG issued a report on Medicare’s 2-midnight rule titled “Vulnerabilities Remain Under Medicare 2-Midnight Hospital Policy.” The report reviews data from 2013 and 2014 and reaches several...more

Baker Donelson

CMS Re-proposes Ban on Per-Click Fees for Space and Equipment Leases under Stark

Baker Donelson on

In the CY 2017 Medicare Physician Fee Schedule (CY 2017 MPFS), the Centers for Medicare & Medicaid Services (CMS) issued proposed updates to the physician self-referral law (Stark law). The primary Stark law update focused on...more

Alston & Bird

A&B Healthcare Week in Review

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I. REGULATIONS, NOTICES, & GUIDANCE - On April 21, 2016, CMS issued a proposed rule entitled, “Medicare Program: FY 2017 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements.” This...more

King & Spalding

Also In The News - Health Headlines - April 2015 #4

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CMS Announces Round 1 2017 DMEPOS Competitive Bidding System – On April 21, 2015, CMS announced plans for a new bidding process for the supplier contracts awarded in the Round 1 Recompete of the DMEPOS Competitive Bidding...more

Baker Donelson

OIG Calls for Increased Scrutiny on Hospital Outlier Payments

Baker Donelson on

In a recent report [PDF], the Department of Health and Human Services Office of the Inspector General (OIG) highlighted hospital outlier payment trends it found troubling: Of the nearly 3,200 hospitals reviewed, approximately...more

King & Spalding

OIG Report Calls for Increased Scrutiny Over Medicare Hospital Outlier Payments

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The OIG recently issued a report concluding that Medicare hospital outlier payments warrant increased scrutiny by CMS. Outlier payments are supplemental payments to hospitals that are designed to protect hospitals from...more

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