decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
OIG Investigation Procedures / Exclusion of Providers for Quality of Care Issues / Developing Quality of Care Issues / Developing Quality of Care Cases
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Article Overview
This premium article provides guidance related to OIG investigation procedures for quality of care cases, with emphasis on provider exclusion matters and the steps special agents are instructed to follow. It is intended for coding, compliance, and healthcare audit audiences who need to understand how quality-of-care investigations are framed and managed at a high level. The article focuses on procedural guidance and related oversight context rather than clinical coding decisions.
Why This Topic Matters
Readers involved in compliance, auditing, or provider oversight may need this article to understand the OIG’s approach to quality-of-care investigations and exclusion-related case development.
What You Will Learn
- How the article frames OIG quality-of-care case development
- The broader relationship between quality-of-care issues and provider exclusion
- The general procedural context used for these investigations
- The types of compliance-oriented guidance addressed by the article
Who Should Read This
- Coding professionals
- Compliance staff
- Healthcare auditors
- Revenue integrity teams
- Provider enrollment and credentialing personnel
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