OIG Investigation Procedures / Handling of Cases

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This premium article outlines the HHS Office of Inspector General’s investigation priorities and how it routes certain matters to other authorities. It is useful for compliance professionals, health care administrators, and coding or billing teams who need to understand the general scope of OIG investigative activity and the kinds of cases that may be referred elsewhere. The article focuses on broad investigation categories, referral pathways, and matter types that are typically outside OIG’s own handling.

Why This Topic Matters

Understanding which matters OIG handles versus refers helps organizations recognize oversight boundaries and the agencies that may become involved in a case.

What You Will Learn

  • The main categories of investigations OIG prioritizes
  • How OIG handles criminal and non-criminal matters at a high level
  • Which types of cases may be referred to other agencies
  • What kinds of matters are generally outside OIG investigation scope

Who Should Read This

  • Compliance professionals
  • Health care administrators
  • Medical billing staff
  • Coding professionals
  • Risk management teams

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