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October 27th, 2020
OIG – Fraud and Abuse Study with COVID-19 Testing
Published October 27th, 2020|
According to the Office of Inspector General (OIG), “The coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented demand for diagnostic laboratory testing to determine whether an individual has the virus. Beyond the COVID-19 tests, laboratories can also perform add-on tests, for example, to confirm or rule out diagnoses ...
July 28th, 2020
OIG Report Highlights Need to Understand Guidelines
Published July 28th, 2020|
A new OIG report once again highlights the necessity for organizations to fully understand requirements for reporting services and having proper documentation. The types of problems addressed in this report are ongoing issues for multiple types of services and specialties and for many different payers.
July 21st, 2020
Office of Inspector General Says Medicare Advantage Organizations are Denying Services Inappropriately
Published July 21st, 2020|
We attended the recent virtual RISE National Conference and had the opportunity to listen to presenters share their knowledge about risk adjustment and HCC reporting and data validation. Among the presenters were representatives from the Office of Inspector General (OIG), who presented findings from encounter data from 2012-2016. They began ...
April 20th, 2020
Now That is Fraud! Genetic Testing "Public alert"
Published April 20th, 2020|
Genetic testing is becoming very popular. In fact, so popular you might see it in places you would not expect such as a community event, fairs or any event happening in your community. Some labs may even offer FREE screening for genetic testing. Watch for FREE screening announcements or advertisements ...
August 9th, 2019
The OIG Work Plan: What Is It and Why Should I Care?
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 ...
May 17th, 2019
An Update on the DHS OIG's Effort to Combat Fraud & Abuse
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 ...
April 23rd, 2019
OIG Announces New Review For Medicare Part B Payments for Podiatry and Ancillary Services
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 ...
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September 11th, 2019
Inappropriate Payments Made to Chiropractors – An OIG Review
In this webinar, Dr. Gwilliam will take you on a fun filled journey through all of the reports created by the Office of the Inspector General based on their reviews of chiropractors. If you can understand what they see, and what advice they give Medicare when dealing with chiropractors, then you will be better prepared to not become their next target. This webinar may feel a little frightening with hundreds of thousands of dollars paid back to CMS, but, by the end, you will know exactly what to do and what not to do.
August 14th, 2018
How to Create a Medicare Compliance Plan
In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to create an OIG/Medicare compliance plan. He will explain how to create policies, how to perform a "self-test" on your SOAP notes, search the Medicare exclusions list, Stark, anti-kickback and how to handle compliance concerns.
May 8th, 2018
How to Handle High Deductibles, Cash Plans and Pre-Pays
In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to handle high deductibles, pre-pays, discounts, hardships and in-network vs. out-of- network care plans. Learn what the OIG is looking for when it comes to discounts and offering free services.
Complaince Program Guidance for Third-Party Medical Billing CompaniesCompliance Program Guidance for Ambulance SuppliersCompliance Program Guidance for Clinical LaboratoriesCompliance Program Guidance for Home Health AgenciesCompliance Program Guidance for HospicesCompliance Program Guidance for HospitalsCompliance Program Guidance for Individual and Small Group Physician PracticesCompliance Program Guidance for Medicare+Choice OrganizationsCompliance Program Guidance for Nursing FacilitiesCompliance Program Guidance for Pharmaceutical ManufacturersCompliance Program Guidance for the Durable Medical Equipment, Prosthetics, Orthotics, and Supply IndustryDraft Compliance Program Guidance for Recipients of PHS Research AwardsNSTC Government-Wide Initiative for HHS Research GrantsOffice of Inspector General: Questionable Billing for Medicare Ophthalmology Services 2012Office of Inspector General: Questionable Billing for Medicare Ophthalmology Services 2015OIG Compliance Program for Individual and Small Group Physician PracticesOIG Federal RegisterOIG State False Claims Act ReviewsSupplemental Compliance Program Guidance for HospitalsSupplemental Compliance Program Guide for Nursing Facilities
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