News & Analysis as of

Fraud Abuse and Waste Office of the Inspector General

Holland & Knight LLP

OIG Releases New Compliance Program Guidance for All Healthcare Stakeholders

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The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) on Nov. 6, 2023, issued new General Compliance Program Guidance (GCPG) as a reference guide for the healthcare compliance community....more

Venable LLP

OIG Enhanced Review: OIG to Investigate the Life Cycle of Managed Care Contracts

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In August 2023, the Office of Inspector General for the Department of Health and Human Services (OIG) announced a new strategic plan to investigate the life cycle of Medicare Advantage and Medicaid managed care contracts from...more

Holland & Knight LLP

Information Blocking Enforcement Penalties Begin Sept. 1, 2023

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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently posted the final rule establishing civil monetary penalties (CMPs) for information blocking (IB Enforcement Rule). The Rule...more

Benesch

OIG Provides Insight as to Risky Billing Practices for Medicare Telehealth Services

Benesch on

​​​​​​​As part of the Federal government’s response to the COVID-19 pandemic, the coverage of telehealth services by Medicare was greatly expanded by CMS through the COVID-19 telehealth waivers. Further expansion of...more

Health Care Compliance Association (HCCA)

[Virtual Event] Ann Arbor and Columbus Regional Healthcare Compliance Conference - June 24th, 8:25 am - 4:30 pm EDT

General and specialty compliance training from the comfort of your home or office! HCCA’s Regional Healthcare Compliance Conferences provide practitioners with virtual compliance training that includes updates on the...more

Goodwin

OIG Advocates for Increased Oversight of Medicaid Telehealth Services in Behavioral Health

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Telehealth’s exponential growth –in part due to the COVID-19 pandemic – has highlighted both its value in increasing access to care and the potential for misuse. The U.S. Department of Health and Human Services’ Office of...more

Goodwin

Federal Audits and Enforcement Actions of Telehealth Providers: Future Trends and Mitigating Risk

Goodwin on

As the COVID-19 pandemic progresses and the expanded use of telehealth has appeared to stabilize over the past year according to a July report from McKinsey & Company, Federal agencies have continued the recent trend of...more

Mintz - Health Care Viewpoints

The OIG Urges CMS to Implement Solutions to Reduce Fraud in Medicare Part C and Part D

Recently, the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) issued its 2019 “Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: Top Unimplemented Recommendations.” The OIG...more

King & Spalding

OIG Highlights Top 25 Unimplemented Recommendations to Reduce Fraud, Waste, and Abuse in HHS Programs

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OIG recently released its annual publication of Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG’s Top Recommendations (July 2019 Edition). In the July 2019 Edition, OIG focused on the top 25 unimplemented...more

Baker Donelson

Nursing Facility Discounts Approved in OIG Advisory Opinion 17-08

Baker Donelson on

The OIG created an opening for nursing facility discounts to private payors when it approved a startup company's proposal to create a network of nursing facilities willing to offer discounts on the daily rates charged to...more

Foley & Lardner LLP

Time to Review Internal Confidentiality Agreements

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Effective January 19, 2017, pursuant to Federal Acquisition Regulation (FAR) clause 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements, federal government contractors are prohibited...more

Clark Hill PLC

Texas OIG Turns Over New Leaf: MCOs Must Turn Attention to SIUs

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More active SIUs may mean more scrutiny of Medicaid providers - The Texas Office of Inspector General (OIG) has just completed its first full year of reforms under a new Inspector General. 2017 may reveal whether these...more

Hinshaw & Culbertson LLP

OIG Mid-Year Updated Provides Insight To Its Concerns

The Office of Inspector General (OIG) recently released its mid-year update of its Fiscal Year Work Plan for 2016. The Work Plan summarizes new and ongoing reviews and activities that the OIG plans to pursue. Not...more

King & Spalding

OIG Releases Report on Questionable Billing for Medicare Ophthalmology Services

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On September 15, 2015, OIG released a report examining the extent to which ophthalmology services are vulnerable to fraud, waste, and abuse. According to OIG, Medicare paid $6.7 billion to 44,960 providers for ophthalmology...more

Cozen O'Connor

OIG Reports on Questionable Billing for Mental Health Services

Cozen O'Connor on

As its title makes clear, the August 2012 report “Questionable Billing by Community Mental Health Centers” (the Report) by the U.S. Department of Health and Human Services Office of Inspector General (OIG) demonstrates its...more

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