Medicare Compliance & Reimbursement - 2017 Issue 8
Compliance: What's Under the OIG Microscope Right Now? Find Out
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Article Overview
This article summarizes what the HHS Office of Inspector General is focusing on in its latest semiannual reporting period, including fraud and abuse recovery, improper payment drivers, and audit/enforcement attention across multiple program areas. It is relevant to compliance staff, coders, auditors, billing teams, and healthcare leaders who monitor oversight trends affecting Medicare, Medicaid, CHIP, home health, Part D, and device and service billing. The discussion stays at a high level and points readers to broad categories of risk, program integrity concerns, and examples of enforcement activity discussed in the report.
Why This Topic Matters
Understanding current OIG priorities helps healthcare organizations recognize where oversight pressure is increasing and where documentation, eligibility, billing, and program integrity issues are drawing attention. This supports compliance planning and internal audit awareness without replacing the full report.
Article Sections
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Background
Introduces the OIG’s mission, oversight role, and broad approach to fraud prevention and enforcement within HHS programs.
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Fraud and abuse overview
Summarizes recovery activity, enforcement volume, and broad outcomes reported for the period covered by the semiannual report.
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Watch Your Communication Breakdowns, Report Suggests
Focuses on improper payments tied to beneficiary eligibility, communication gaps, and related program integrity issues across government healthcare programs.
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Here Are Some of the Other Highlights on the OIG Hit List
Reviews additional oversight priorities, including home health, Part D-related diversion concerns, and audit findings involving services and devices.
What You Will Learn
- How the OIG frames its current oversight priorities
- Which broad program integrity issues are driving improper payments
- What general service categories are drawing audit attention
- How compliance concerns are being discussed across Medicare, Medicaid, and CHIP
- Why recent enforcement examples are relevant to healthcare organizations
Who Should Read This
- Compliance professionals
- Medical coders
- Billing and reimbursement teams
- Healthcare auditors
- Practice managers
- Healthcare executives
- Revenue integrity staff
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