decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
OIG Investigation Procedures / Investigation of Servicess Not Provided as Claimed / Other Offenses
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Article Overview
This short article summarizes OIG investigation procedures related to suspected services not provided as claimed and the broader search for other provider offenses. It is relevant to investigators, compliance staff, auditors, and healthcare fraud professionals who need a high-level understanding of the sources of information used in these cases.
Why This Topic Matters
It helps readers understand the investigative scope and the types of entities that may supply information in suspected provider misconduct matters.
What You Will Learn
- The general purpose of the investigation guidance
- How additional provider offenses fit into an investigation
- Which types of organizations may serve as information sources
- The broad compliance and fraud-investigation context of the guidance
Who Should Read This
- OIG investigators
- Compliance professionals
- Medical auditors
- Healthcare fraud analysts
- Provider credentialing and integrity staff
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