Learning objectives - Review OIG’s work planning process - Discuss importance of, and best practices for, monitoring OIG Work Plan items - Highlight significant OIG Work Plan items from 2023 - A breakdown of work...more
Report on Medicare Compliance 31, no. 14 (April 18, 2022) - Michigan gynecologic oncologist Vinay Malviya, M.D., has agreed to pay $775,000 to settle false claims allegations in connection with medically unnecessary...more
Learning Objectives: - Discuss OIG work planning process and work plan items - Provide practical advice for reviewing and monitoring work plan items - Highlight significant OIG Work Plan items - 2021 Year in Review ...more
Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more
Richard Church interviews Stephen Bittinger about the scope and authority of OIG and CMS audits, outlining the similarities and differences between the two from a provider perspective. The presenters discuss the key...more
Learning Objectives: - Discuss OIG work planning process, work plan items, and other government reports - Provider insights into COVID-19 audits, reviews, and monitoring... During this program, we will provide an...more
Report on Medicare Compliance 30, no. 15 (April 19, 2021) - CMS’s supplemental medical review contractor (SMRC) has added outpatient therapy claims to its list of postpayment reviews, according to its website. The SMRC,...more
Learning Objectives: - Explain changes to existing concepts including fair market value, commercial reasonableness, and volume or value - Examine the new definitions, exceptions, and safe harbors and their impact on...more
The OIG has indicated concern that patients suffering from opioid use disorder may experience difficulty accessing medication-assisted treatment (MAT), resulting in under-utilization of this intervention that offers what the...more
Report on Medicare Compliance 29, no. 25 (July 13, 2020) - Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers...more
Report on Medicare Compliance Volume 29, no. 22 (June 15, 2020): - The HHS Office of Inspector General has updated its Work Plan, and new items include opioid treatment challenges during the COVID-19 pandemic. - In a...more
Report on Medicare Compliance 29, no. 7 (February 24, 2020) - Guardian Elder Care Holdings Inc., which operates more than 50 skilled nursing facilities (SNFs) in Pennsylvania, Ohio and West Virginia, and its related...more
The OIG updates its Work Plan monthly to identify audits and evaluations that are underway or proposed by the OIG's Office of Audit Services and Office of Evaluation and Inspections. The October 2019 update identifies new...more
Delve into compliance hot topics and issues, including risk adjustment, CMS compliance, ethical leadership, data security, audits, and the challenges of the job. You’ll learn the latest practices, share strategies, and...more
2019 has seen a major focus by federal departments on effective compliance programs at hospitals, clinics, and home health/hospice care. Get the OIG and other government updates you need as a compliance professional or...more
The Office of Inspector General (OIG) for Health and Human Services (HHS) Work Plan describes audits, reviews and other work statutorily required or otherwise undertaken by the OIG. Monthly updates to the OIG Work Plan can be...more
Report on Medicare Compliance 28, no. 38 (Oct. 28, 2019) - - Doctors Hospital of Augusta in Georgia agreed to pay $180,000 in a civil monetary penalty settlement over alleged violations of the Emergency Medical Treatment...more
In its recently updated Work Plan, the Office of the Inspector General (“OIG”) at the Department of Health & Human Services (HHS) announced that it will conduct an audit focusing on how selected state Medicaid agencies and...more
On December 28, 2018, the U.S. Department of Health and Human Services (“HHS”) closed out the year by releasing long-awaited voluntary cybersecurity guidelines for the health care industry. The four-volume publication,...more
The OIG added five new items to its Work Plan in the October 2018 update: (1) childcare provider compliance with criminal background check requirements; (2) early results from Opioid State Targeted Response Grants; (3)...more
The OIG added two new items to its Work Plan in the September 2018 update: (1) a review of opioid use in the Indian Health Service (IHS), and (2) a follow-up review of a New York Head Start grantee....more
The OIG added 12 new items to its Work Plan in the August 2018 update. Hot topics related to Centers for Medicare & Medicaid Services (CMS) oversight in this month's Work Plan include: state oversight of opioids; potential...more
The OIG added six new items to its Work Plan in the July 2018 update. Areas addressed include HHS cybersecurity vulnerabilities, increased payments for transfer claims with outliers, oversight of funds for Access Increases in...more
Last summer, we alerted our clients to the OIG's inclusion of telehealth claims to its work plan, and we now see the results of the OIG's focused review in a report first released at the beginning of April....more
The OIG's April 2018 Work Plan update added six new items to its active list of scheduled audits, inspections, and evaluations. The OIG indicates its intention to review beneficiary access to drugs under Part D, as well as...more