decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Operation Restore Trust / ORT Targets and Actions / Nursing Homes
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Article Overview
This article covers a nursing home-focused segment of Operation Restore Trust (ORT), describing the types of billing problems investigators looked for and giving case examples of enforcement actions. It is relevant to compliance, auditing, and health care fraud oversight professionals who want a general sense of the issue areas addressed in ORT nursing home investigations.
Why This Topic Matters
Understanding the scope of ORT nursing home initiatives helps compliance teams recognize the general fraud-and-abuse themes that drew government attention and the kinds of allegations that led to investigations and penalties.
What You Will Learn
- The general fraud and abuse concerns targeted in nursing home-related ORT reviews
- How investigators and enforcement agencies approached suspected billing misconduct
- The broad nature of example cases involving nursing home-related claims activity and resulting actions
- Why this ORT topic is relevant to compliance and audit awareness
Who Should Read This
- Healthcare compliance professionals
- Medical coders
- Billing auditors
- Fraud and abuse investigators
- Provider administrators
- Health care attorneys
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