ED Coding & Reimbursement Alert - 2017 Issue 11
Compliance: Fraud and Abuse: OIG Targets Opioid Abuse, Home Health, and Children's Health
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Article Overview
This article summarizes an HHS Office of Inspector General compendium of unimplemented recommendations and the broad oversight areas the agency continues to emphasize. It is relevant to compliance, fraud and abuse, reimbursement, and health information technology stakeholders who track Medicare and related federal program integrity issues. The piece covers major program areas, the agencies involved, and the kinds of operational and payment concerns identified in the report.
Why This Topic Matters
The article helps readers understand where federal oversight is focusing, including program integrity, payment policy, care delivery, and electronic health record vulnerabilities. It is useful for organizations assessing compliance risk and anticipating areas of future regulatory attention.
Article Sections
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Background
Introduces the compendium and its role in summarizing unimplemented recommendations across HHS programs and related federal agencies.
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Top issues
Lists the major HHS priority areas that the OIG says remain under continued scrutiny.
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OIG Homes In On Medicare
Reviews the Medicare program areas highlighted by the OIG, including payment and oversight concerns across multiple parts of the program.
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SNFs Come Under Fire
Focuses on skilled nursing facility payment oversight and related Medicare program integrity concerns.
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EHR Concerns Persist
Discusses persistent fraud vulnerabilities associated with electronic health records and the agencies involved in addressing them.
What You Will Learn
- How the OIG organizes unimplemented recommendations across federal health programs
- Which broad Medicare and Medicaid issue areas remain priorities for oversight
- What types of payment, documentation, and program integrity concerns are emphasized
- Why electronic health record fraud vulnerabilities remain a compliance focus
- Which federal agencies are mentioned in connection with the report
Who Should Read This
- Health care compliance professionals
- Medical billing and coding professionals
- Hospital and health system administrators
- Medicare and Medicaid program staff
- Health information management and health IT leaders
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