Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

OIG

Healthcare Supply Chain Issues Cause VA Center Director Change

April 17, 2017 - 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 concerns stemming from healthcare supply chain management inadequacies. Charles Faselis, MD, will be the acting Medical Center Director while the VA reviews the OIG findings from March 2017....


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

by Jacqueline Belliveau

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 received improper Medicaid reimbursement...

OIG Finds Medicare Payment Problems with Two-Midnight Policy

by Jacqueline Belliveau

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 Two-Midnight policy. Using hospital and provider...

OIG: Provider Support, Health IT Needed for MACRA Implementation

by Jacqueline Belliveau

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 could impede Quality Payment Program...

OIG Identifies Top HHS Financial, Medicare Fraud Challenges

by Jacqueline Belliveau

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 management and Medicare fraud prevention inefficiencies....

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 below result in multiple millions of dollars...

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 below result in multiple millions of dollars...

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 below result in multiple millions of dollars...

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 General of the OIG Office of Evaluation and Inspections,...

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 below result in multiple millions of dollars...

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 (OIG). If swing-bed services at CAHs —...

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 dollars in healthcare fraud and the possibility...

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 Health and Human Service (HHS) Office of Inspector...

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 Inspector General’s (OIG) proposed revisions...

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 released the results of a six year audit of Highmark...

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 most significant management and performance...

Palmetto Received $14K in Unallowable Medicare SERP III Costs

by Ryan Mcaskill

Palmetto Government Benefits Administrator unintentionally misfiled SERP III costs during the fiscal years 2010 and 2011. Recently, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the audit results...

Human Error Causes $319K in Medicare Overpayment to Hospital

by Ryan Mcaskill

Medicare noncompliance caused Queen’s Medical Center to receive $319,000 in overpayments during a three year audit period. Recently, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the results...

Medicare Part D Payments Made to Deceased Beneficiaries

by Ryan Mcaskill

An OIG report found that Medicare Part D paid HIV drugs for over 150 deceased beneficiaries in 2012. The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released a study of the Centers for Medicare & Medicaid...

OIG Releases 2015 Work Plan for CMS Investigative Initiatives

by Ryan Mcaskill

The fiscal year of 2015 will include audits, evaluations and other legal investigative members of HHS agencies. The U.S. Department of Health and Human Services (HHS) Office of Inspector General has released its “Work Plan” for the fiscal...

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