OIG

Medicare Hospice and Home Health Fraud, Part 2

by

Late last week, I posted the first part of a three-post, comprehensive review of Medicare hospice and home health fraud. Medicare home health and hospice billing fraud has emerged as a significant issue within the U.S. healthcare system, costing taxpayers billions of dollars annually and jeopardizing the integrity of federal health programs. This is part … Read more

Medicare Hospice and Home Health Fraud, Part 1

by

Medicare home health and hospice billing fraud has emerged as a significant issue within the U.S. healthcare system, costing taxpayers billions of dollars annually and jeopardizing the integrity of federal health programs. Fraudulent practices in this sector not only drain public resources but also compromise the quality of care provided to vulnerable populations, including the … Read more

OIG: CMS Should Take Action Against States with Poor SNF Survey Performance

by

Last week, the U.S. Department of Health and Human Services Office of the Inspector General (OIG), issued a report regarding the performance of contracted state agencies with respect to nursing home (SNF) compliance surveys. CMS contracts with state agencies, typically state departments of health or divisions thereto, to perform compliance/regulatory activities (surveys) in nursing homes. The report … Read more

OIG Issues Report on SNF Emergency Preparedness

by

Since the COVID pandemic, regulatory officials have escalated the review, via various audits, of SNF emergency preparedness. COVID highlighted the sporadic and often, non-existent preparations for disasters (natural and other) and disease outbreaks (pandemic or other) that existed with the SNF industry. In reality, the issues have been present for years but only regionally, highlighted … Read more

Blast from the Past – Duties of Boards: An OIG Perspective

by

There are nearly 300 articles/posts on this site and from time to time, I’m going to repost an “oldie but a goodie” that is as applicable now as it was when I originally wrote it.  This is from July of 2009.  This follows well with Tuesday’s piece on OIG initiatives and SNFs…https://wp.me/ptUlY-BJ This seemed to … Read more

OIG Initiatives for SNFs

by

On the heels of a report released in January of this year, the Office of Inspector General for the Department of Health and Human Services has created a series of regulatory reviews/quality initiatives for SNFs. The report focuses on the SNF experience during COVID and what, in the opinion of the OIG analysts, regulatory interventions … Read more

SNFs, Therapy Contracts and Fraud: Another Warning and Example

by

I know I sound redundant but clearly, the message is still not permeating through the industry (except for readers here). The Department of Justice and the OIG for the Department of Health are scrutinizing SNFs, their therapy billings, and the use of therapy contractors.  Why?  It is all due to a known and now routinely … Read more

Post-Acute Compliance 2015: OIG Targets

by

As is customary in late fall, the Office of the Inspector General (OIG) of the Department of Health and Human Services released its Fiscal Year work plan.  As a reminder or preface, the work plan is the summary of investigations and focal areas the OIG plans to undertake in the upcoming fiscal year and beyond … Read more