OIG

OIG Identifies What Makes Accountable Care Organizations Successful

by Jacqueline LaPointe

Accountable care organizations (ACOs) have reduced Medicare spending and improved care quality, but some organizations are doing it better than others, the HHS Office of the Inspector General (OIG)...

OIG Nabs AZ Hospital for Submitting Inaccurate Wage Index Data

by Jacqueline LaPointe

St. Joseph’s Hospital and Medical Center in Phoenix, Arizona, overstated wage index data by over $12.3 million, which would have significantly impacted Medicare reimbursement rates for hospitals...

CMS Paid $4M in Excess GME Medicare Reimbursement, OIG Finds

by Jacqueline LaPointe

Audits performed by the HHS Office of Inspector General (OIG) showed that hospitals received excess Graduate Medical Education (GME) Medicare reimbursement after counting residents and interns as more...

OIG: Practice Aid, QPP Integrity Needed for MACRA Implementation

by Jacqueline LaPointe

A recent Office of the Inspector General (OIG) investigation found two major vulnerabilities with MACRA implementation. The HHS watchdog reported that CMS still needs to provide practice-specific...

Healthcare Supply Chain Issues Cause VA Center Director Change

by Jacqueline LaPointe

The VA recently removed its medical center director from his position and temporarily reassigned him to administrative duties after the Office of Inspector General (OIG) reported several patient safety...

OIG: NJ Agency Falsely Claimed $95M in Medicaid Reimbursement

by Jacqueline LaPointe

New Jersey’s Department of Health and Human Services may have to repay the federal government almost $95 million after the Office of the Inspector General (OIG) recently found that the state agency...

OIG Finds Medicare Payment Problems with Two-Midnight Policy

by Jacqueline LaPointe

Hospitals may face more Medicare reimbursement audits on inpatient and outpatient claims after the Office of the Inspector General (OIG) recently found several vulnerabilities associated with the...

OIG: Provider Support, Health IT Needed for MACRA Implementation

by Jacqueline LaPointe

MACRA implementation has been a major priority for CMS in the past year, but the Department of Health and Human Service’s Office of the Inspector General (OIG) recently found several challenges that...

OIG Identifies Top HHS Financial, Medicare Fraud Challenges

by Jacqueline LaPointe

The Office of the Inspector General (OIG) recently found the most significant management and performance challenges facing the Department of Health and Human Services (HHS), including financial...

October 30: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported...

July 17: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported...

July 10: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported...

OIG Testimonies Examine 340B Savings and Medicare Fraud

by Jacqueline DiChiara

The Office of the Inspector General (OIG) recently posted written testimonial on 340B savings and Medicare fraud, as submitted to the House of Representatives from Ann Maxwell, Assistant Inspector...

March 13: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported...

High Critical Access Hospital Reimbursement Costs Medicare

by Jacqueline DiChiara

Swing-bed services provided at 90 percent of critical access hospitals (CAHs) could have been avoided by use of neighboring alternative facilities during 2010, reports the Office of Inspector General...

Feb. 27: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice. The crimes reported below result in multiple millions of...

New York State Agency Made $79K in Inappropriate Medicaid Claims

by Stephanie Reardon

State agency claimed Medicaid reimbursement for some home and community-based services provided by New York City providers that did not comply with Federal and State requirements. The Department of...

AHA Reacts to Proposed Anti-Kickback Statute Revisions

by Stephanie Reardon

AHA Executive Vice President Rick Pollack issued comments describing the statute as “outdated regulatory barriers.” The American Hospital Association (AHA) is speaking out against the Office of...

Highmark Over Claims $1.4M in Postretirement Benefits

by Ryan Mcaskill

A recent audit of Highmark Medicare Services found that the company claimed unallowable Medicare Benefits. Recently, the Department of Health and Human Services (HHS) Office of Inspector General...

OIG Releases 2014 Top Management and Performance Challenges

by Ryan Mcaskill

OIG released its annual analysis of the top current and future challenges facing the Department of Health and Human Services. Every year, the Office of Inspector General (OIG) prepares a summary of the...