News and Important Information
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October 15th, 2019
Now That is Fraud! Genetic Testing "Public alert"
Published October 15th, 2019|
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 ...
May 30th, 2018
Creating a Culture of Compliance in 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...
April 23rd, 2018
Brooklyn Chiropractor OIG Report - Lessons Learned
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.
January 22nd, 2018
Compliance: What is it and Why is it Important
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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March 21st, 2019
September 10, 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.
June 26th, 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.
March 28th, 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.
February 16th, 2018
This presentation will review how risk management is no longer limited to just malpractice claims. It also includes your financial policy. There is now a greater risk of financial loss due to improper discounting and faulty financial and collection policies than ever before. It is widely known that the Office of Inspector General (OIG) and Medicare are cracking down on healthcare fraud and abuse, but what most chiropractors are unaware of, is how widely successful these efforts have been. In this presentation, we will identify the five most dangerous things we face in chiropractic and how to avoid them. All attendees will receive a free sample 1-page financial policy that can be customized for their practice and a link to receive a free risk assessment score for their practice.
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 Report FraudOIG Accountable Care OrganizationsOIG COmplianceOIG Compliance 101OIG Compliance Program for Individual and Small Group Physician PracticesOIG Employee Exclusions DatabaseOIG Exclusion- Applying for ReinstatementOIG Federal RegisterOIG FraudOIG Roadmap for New PhysiciansOIG Self-Disclosure InformationOIG State False Claims Act ReviewsOIG Work PlanOIG Work PlanSupplemental Compliance Program Guidance for HospitalsSupplemental Compliance Program Guide for Nursing Facilities
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