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OIG Releases Compliance Program Guidance Applicable to All Providers and Suppliers

On November 6, 2023, OIG released new General Compliance Program Guidance (General CPG). The General CPG applies to all individuals and entities involved in the healthcare industry. The release of the General CPG was not...more

OIG Publishes the Spring 2023 Semiannual Report to Congress

OIG released its Semiannual Report to Congress (the Report) which summarizes the agency’s activities from October 1, 2022, through March 31, 2023 (the Reporting Period). Among other accomplishments, the Report highlights...more

OIG Adds New Nationwide Inpatient Rehabilitation Facility Audit to Work Plan

This month, OIG updated its work plan to include a new Inpatient Rehabilitation Facility (IRF) Nationwide Audit. In explaining the new workstream, OIG cited high IRF error rates in other reviews and plans to determine whether...more

OIG Updates its Corporate Integrity Agreement Model

OIG periodically makes updates to its Integrity Agreement (IA) and Corporate Integrity Agreement (CIA) model language. It is important for healthcare organizations – even those not subject to a CIA – to monitor changes to...more

DOJ and HHS Issue Healthcare Fraud and Abuse Control Program Fiscal Year 2021 Report

Last week, DOJ and HHS-OIG published its annual report regarding the Healthcare Fraud and Abuse Control (HFAC) Program (the Report). The Report summarizes the enforcement activity of DOJ and HHS and states that during Fiscal...more

OIG Publishes the Spring 2022 Semiannual Report to Congress

On June 6, 2022, OIG released its Semiannual Report to Congress (the Report) which summarizes the agency’s activities from October 1, 2021 through March 31, 2022 (the Reporting Period). Among other accomplishments, the...more

OIG Issues Semiannual Report to Congress

In December 2021, OIG issued its Semiannual Report to Congress (SAR) covering OIG’s activities for the reporting period of April 1, 2021 through September 30, 2021, as well as the entire Fiscal Year (FY) 2021 (October 1, 2020...more

OIG Updates the Self-Disclosure Protocol

On November 8, 2021, OIG released an update to the Self-Disclosure Protocol (SDP). The revised SDP includes a name change for the SDP, increased minimum amounts required to settle under the SDP, a requirement that SDP...more

OIG Issues Report Regarding Medicare Oversight of Cybersecurity for Networked Medical Devices in Hospitals

On June 21, 2021, OIG released a report titled “Medicare Lacks Consistent Oversight of Cybersecurity for Networked Medical Devices in Hospitals” (OEI-01-20-00220) (the OIG Report). OIG determined that CMS’s accreditation...more

OIG Announces Resumption of Medicare Inpatient Short Stay Audits

In its November 2020 Work Plan update, OIG announced it will begin auditing short stay inpatient hospital claims under the Two Midnight Rule, and when appropriate, recommend overpayment collections. OIG does not specify the...more

OIG Releases Report Regarding Reasonable Assumptions in Manufacturer Reporting of Average Manufacturer Prices and Best Prices for...

On September 18, 2019, OIG released a report assessing a sample of drug manufacturers participating in the Medicaid Drug Rebate Program to identify the primary areas in which they make assumptions when calculating average...more

OIG Issues Request for Information Regarding the Anti-Kickback Statute and Beneficiary Inducements Civil Monetary Penalty

On August 27, 2018, the Office of Inspector General (OIG) of the Department of Health & Human Services (HHS) published a request for information (RFI) inviting comments regarding the Anti-Kickback Statute and Beneficiary...more

OIG Report Finds Medicare Inappropriately Paid Hospitals for Certain Outpatient Services

Last week, HHS OIG released a report finding that Medicare inappropriately paid acute-care hospitals for outpatient services provided to beneficiaries who were inpatients of other facilities, such as long-term care hospitals,...more

9/29/2017  /  Hospitals , Medicare , OIG , Outpatient Services

Genesis Healthcare Enters $53.6 Million Settlement

On June 16, 2017, the Department of Justice announced that Genesis Healthcare paid $53.6 million to resolve six False Claims Act whistleblower lawsuits filed by seven of Genesis’ former employees. The lawsuits alleged that...more

Senate Finance Committee Releases Report on Concurrent and Overlapping Surgeries

On December 6, 2016, Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.) issued a Committee staff report detailing concurrent and overlapping surgery practices. The report also offers...more

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