ED Coding & Reimbursement Alert - 2022 Issue 9
Compliance: Increase Your PHE Fraud Awareness With This OIG Report Overview
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Article Overview
This article summarizes an HHS Office of Inspector General semiannual report and related enforcement activity focused on fraud and abuse tied to the COVID-19 public health emergency. It is aimed at healthcare compliance and coding professionals who want a high-level understanding of audit trends, enforcement priorities, and the general categories of Medicare-related schemes discussed in the report.
Why This Topic Matters
The article helps readers understand current fraud and abuse enforcement trends that can affect compliance efforts in physician practices and other healthcare settings. It is especially relevant for teams monitoring telemedicine, durable medical equipment, and Medicare program integrity issues.
Article Sections
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Feds Focus on PHE Tricksters and Recover Pay
An introduction to the article’s focus on fraud and abuse activity connected to the COVID-19 public health emergency. It frames the HHS OIG report as the basis for the discussion.
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Context
Background on the HHS Office of Inspector General semiannual report and the reporting period covered. This section also notes the report’s broader program integrity and recovery goals.
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Statistics
A summary of report-level audit, investigative, criminal, civil, exclusion, and recovery activity. It presents the major enforcement and recovery measures highlighted by OIG.
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Check Out These Top Medicare Enforcement Cases
An overview of the article’s examples of Medicare-related enforcement matters discussed in the report. The section introduces the general types of schemes and program areas covered.
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Telemedicine
Discussion of telemedicine-related fraud themes described in the report. The section covers the role of remote services and related abuse concerns at a high level.
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More
Additional telemedicine-related enforcement activity summarized from the report. The section continues the article’s high-level review of Medicare and federal program fraud cases.
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DME
A brief overview of enforcement activity involving durable medical equipment. The section summarizes the article’s compliance focus on improper inducements and related allegations.
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Resource
A reference to the source report for readers who want to review the underlying OIG publication. This serves as the article’s citation and external resource point.
What You Will Learn
- The general purpose and scope of the HHS OIG semiannual report discussed in the article.
- What types of fraud and abuse enforcement activity were emphasized during the reported period.
- Which broad program integrity issues were highlighted for Medicare and related federal healthcare programs.
- How the article frames telemedicine and durable medical equipment as compliance focus areas.
- Where the underlying OIG report can be found for additional review.
Who Should Read This
- Healthcare compliance professionals
- Medical practice managers
- General surgery practices
- Medical coders
- Auditors
- Revenue integrity teams
- Physician office administrators
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