Enforcement: OIG Targets Opioid Fraudsters in New Report

Why This Topic Matters

The report signals where federal scrutiny is increasing and helps providers, suppliers, and compliance teams understand the types of risk areas drawing enforcement attention. It is useful for organizations that want to benchmark their own billing, documentation, and compliance programs against current oversight priorities.

Article Sections

1. Enforcement Overview and FY 2018 Statistics

   Summarizes the report’s overall enforcement and recovery activity for the fiscal year. It also describes the agencies and program integrity partners involved in federal oversight efforts.

2. Top Program Integrity Priorities

   Outlines the broad oversight themes emphasized by the agency leadership. This section focuses on the major areas of future scrutiny discussed in the report.

3. Review These Examples

   Introduces selected examples highlighted in the report as illustrations of the agency’s oversight work. The section frames several issue areas discussed later in the article.

4. Telehealth Site Issues

   Discusses telehealth claim review activity and a billing-related discrepancy identified through audit work. It also addresses the broader growth of telehealth payments over time.

5. Opioid Enforcement

   Covers enforcement activity related to opioid fraud and abuse, including a major takedown and related exclusion activity. This section reflects one of the agency’s major fraud priorities.

6. Senior Medicare Patrol (SMP) Project

   Summarizes outreach and fraud-prevention efforts conducted through SMP projects. It also notes recoveries associated with community-based education and reporting efforts.

7. Replacement Positive Airway Pressure Device Claims Errors

   Reviews audit findings involving claims submissions for durable medical equipment supplies. The section addresses oversight findings tied to replacement PAP device claims and Medicare payment accuracy.

8. Compliance Takeaway

   Ends with a general reminder about billing compliance and self-audit readiness. It encourages readers to evaluate internal practices in light of federal oversight trends.