OIG Investigation Procedures / Investigation of Servicess Not Provided as Claimed / Overpayments

Article Overview

This article explains the Medicare and Medicaid overpayment issues that can arise when services were billed improperly and how those issues are handled in the context of OIG civil money penalty case referrals. It is aimed at compliance, billing, audit, and investigative audiences that need a general understanding of how overpayment calculations, repayments, and related postpayment review findings are treated during an OIG investigation. The discussion focuses on broad procedural and coordination considerations involving federal programs and agency review processes.