Posts Tagged ‘OIG’
OIG to CMS: Use Compliance Audits to Create Better Oversight
Last month, the Office of Inspector General (OIG) published a report based on a series of 12 audits conducted during calendar years 2016 through 2018. Its purpose was to determine whether the claims were billed appropriately, whether the Centers for Medicare & Medicaid Services’ (CMS) took action regarding recommendations in the audits and how CMS…
Read MoreTexas MD Faces Significant Prison Time for TRICARE Fraud
A Texas physician faces significant time behind bars after being convicted of engaging in a scheme to fraudulently bill TRICARE, for toxicology and genetic tests that were not provided as represented and/or were medically unnecessary. TRICARE is the healthcare program for uniformed service members, retirees, and their families, Dr. Sekhar Rao, a vascular and interventional…
Read MoreOIG Report: CMS Fails to Collect Millions in Overpayments
The Centers for Medicare and Medicaid (CMS) failed to collect a large portion of Medicare overpayments identified over a two-year period between 2014 and 2016, according to an audit conducted by the U.S. Department of Health and Human Services Office of Inspector General. According to the watchdog agency, of $498 million in Medicare overpayments identified…
Read MoreStates Benefit from Multimillion-Dollar FCA Urine Test Lab Settlement
Several states are now benefiting from a multimillion-dollar settlement agreement signed late last year by a Nevada clinical lab and two of its owners who were charged with submitting false claims for payment to federal healthcare programs. Nevada Attorney General Aaron D. Ford recently announced that his state would receive $335,000 of the settlement money…
Read MoreOIG Report: Genetic Tests Pose Risk for Fraud and Abuse
The use of genetic testing to determine the risk of developing certain diseases has taken off in recent years. And while they can help healthcare providers and their patients better understand the potential for future health problems and make informed decisions about their healthcare, their use also opens the door to fraud and abuse. A…
Read MoreHome Health Agency Settles Allegations Relating to Excluded Provider
A Connecticut home healthcare company and its owner have agreed to pay a little more than $28,000 to settle allegations that they improperly employed a physical therapist who had been excluded from all federal healthcare programs. The U.S. Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals…
Read MoreOIG Doubles Healthcare Fraud Recoveries in 2019
OIG Cracks Down on Home Health Questionable Billing Practices
A few years back, as part of its Work Plan, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) announced it was seeking to identify home health agencies, supervising physicians, and geographic areas whose Medicare claims had characteristics similar to those observed by the agency in cases of home health…
Read MoreTis the Season: Gifts to Medicare Patients Nice Gesture or a Crime?
As we approach the holidays, now may be an appropriate time to point out the rules relating to gifts that providers can give to Medicare and Medicaid beneficiaries. During this time of the year, some healthcare professionals may want to give gifts to their patients, other physicians or even referral sources. Before you do, consider…
Read MoreOIG: CMS Overpaid Providers Millions in EHR Incentive Payments
The Department of Health and Human Services’ Office of Inspector General (OIG) recently released a report finding that the Centers for Medicare & Medicaid Services (CMS) overpaid some $729 million in Medicare electronic health record (EHR) incentive payments to eligible providers who did not comply with federal meaningful use requirements. In its report, the OIG…
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