There are many misunderstandings in the compliance world on how CIAs are used and whether or not the OIG is obligated to enter into one. The OIG does not have to enter into a Corporate Integrity Agreement, nor does a provider have an automatic right to one.Read More
The OIG has heard and seen it all, right? It is hard to imagine the daily insanity of discovering and investigating fraudulent behavior within the healthcare industry. One thing is for sure; they are not messing around.Read More
The case highlights a major concern for the OIG, as outlined in the 2017 OIG Work Plan. The OIG Work Plan specifically addresses nursing home/facility fraud concerns, stating that, "Previous OIG work found that (skilled nursing facilities) are billing for higher levels of therapy that were provided or were reasonable or necessary." So the OIG proposed to and, in this case, reviewed documentation at selected skilled nursing facilities to determine it met the requirements for each particular resource utilization group. The involved sophisticated data mining and analytics, now deployed at the OIG.
Healthcare liability is getting personal. Following the Sally Yates Memo, the DOJ has set certain guidelines and let it be known that they will pursue the individuals personally for their role in committing fraud.
In this blog we discuss a few cases that show that although Sally Yates may not personally be there to lead the charge, but the bull is definitely out of the cage.Read More
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