tci Medicare Compliance & Reimbursement - 2010 Issue 22
Compliance: Glean These 3 Themes From the 2011 OIG Work Plan
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Article Overview
This article reviews three broad compliance themes drawn from the 2011 HHS Office of Inspector General work plan. It is aimed at healthcare compliance, reimbursement, and provider-operations audiences that follow federal oversight trends affecting nursing facilities, hospices, hospitals, and post-acute care relationships. The discussion focuses on how the work plan reflects broader agency attention to provider interactions, rehospitalization patterns, bundled-payment policy, and increased fraud-and-abuse scrutiny.
Why This Topic Matters
The article helps readers understand where federal oversight attention was trending in 2011 and why that mattered for provider compliance planning. It is especially relevant for organizations that coordinate care across settings and want to anticipate audit, payment, and enforcement priorities.
Article Sections
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Theme 1: Interplay Between Sectors and Other Providers
Discusses how the work plan reflects attention to relationships among different provider types and care settings. It also addresses broader oversight interest in cross-setting utilization patterns and related compliance concerns.
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Theme 2: Rehospitalization Rates
Summarizes the article’s discussion of hospitalization and rehospitalization as a focus of federal review. It covers the connection between quality oversight, payment trends, and care transitions across settings.
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Theme 3: Fraud and Abuse Scrutiny
Explains the article’s discussion of heightened enforcement and compliance pressure. It covers government oversight trends involving fraud-and-abuse review and the broader compliance environment.
What You Will Learn
- How the 2011 OIG work plan reflects broader compliance priorities
- Why relationships among hospitals, nursing facilities, and hospices matter for oversight
- How rehospitalization trends connect to payment and quality concerns
- What the article says about increased fraud-and-abuse scrutiny in healthcare
Who Should Read This
- Healthcare compliance professionals
- Medical coders and reimbursement staff
- Hospital and post-acute care administrators
- Nursing facility leaders
- Hospice providers
- Healthcare attorneys and consultants
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