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OIG Compliance Articles
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The OIG Work Plan: What Is It and Why Should I Care?
August 9th, 2019
Published August 9th, 2019 - Last Review/Update August 14th, 2019|
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
An Update on the DHS OIG's Effort to Combat Fraud & Abuse
May 17th, 2019
Published May 17th, 2019 - Last Review/Update May 21st, 2019|
An Update on the DHS OIG's Effort to Combat Fraud & Abuse Every year, the Department of Health and Human Services (DHS) Office of Inspector General (OIG) is required by law to release a report detailing the amounts deposited and appropriated to the Medicare Trust Fund, and the source of such ...
OIG Announces New Review For Medicare Part B Payments for Podiatry and Ancillary Services
April 23rd, 2019
Published April 23rd, 2019|
Due to prior OIG work identifying inappropriate payments for podiatrists and ancillary services, the OIG announced in Feb 2019 they will begin a new review starting in 2020. The OIG stated they will review Medicare Part B payments to determine if medical necessity is supported in accordance with Medicare requirements. Part of the ...
Creating a Culture of Compliance in 2018
May 30th, 2018
Published May 30th, 2018 - Last Review/Update June 4th, 2018|
This year (2018), healthcare organizations (Hospitals, Health Systems, and Physician Groups/Practices) must focus on the criticality of creating a culture of compliance to ensure effectiveness and efficiency. Focusing on "compliance"-only approaches leaves healthcare organizations exposed to areas of liability oftentimes far more than what they could ever imagine or even...
Brooklyn Chiropractor OIG Report - Lessons Learned
April 23rd, 2018
Published April 23rd, 2018 - Last Review/Update February 28th, 2019|
In August of 2017, a Brooklyn chiropractor was ordered to repay $672,805 to Medicare because the reviewer found that 100% of the claims reviewed (from 2011-2012) did not meet medical necessity requirements. The chiropractor enlisted help from two reputable experts who disputed the findings of Medicare’s Professional Reviewer (MPR). However, the OIG maintained that the findings of the original auditor were valid. Since none of us have ½ million in cash just laying around, it is essential to learn, understand, and make changes where appropriate to help audit-proof patient documentation. Read here to learn more.
Compliance: What is it and Why is it Important
January 22nd, 2018
Published January 22nd, 2018 - Last Review/Update January 25th, 2018|
Compliance. It is one of the buzz words in healthcare that is heard all the time but what is it really, and why is it so important?
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