Tag: OIG

OIG: CMS should offer agencies more infection control guidance

CMS should develop and share more information on COVID-19 infection prevention and control best practices that home health providers can use to comply with requirements and guidance, according to a new report from the Department of Health and Humans Services Office of Inspector General (OIG). Six of eight home health agencies recently audited by the […]

OIG audit questions full episodes for limited services

The latest home health agency audit by the Department of Health and Human Services Office of Inspector General (OIG) highlights a frequent topic for OIG reviews: questioning the need for homebound services mid-episode. OIG claimed that 17 of the 100 claims it reviewed from Catholic Home Care were incorrectly billed. Sixteen of those claims were […]

‘Telehealth 2.0’ is goal of OIG reviews

The Department of Health and Human Services Office of Inspector is reviewing telehealth use during the pandemic with an eye on building the blueprint for “telehealth 2.0,” according to Principal Deputy Inspector General Christi Grimm. The OIG recently shared comments Grimm made to the American Health Law Association’s annual meeting June 29, and telehealth was […]

Hospice pays $500,000 after allegedly failing to recertify terminal illness

After it self-disclosed conduct, an Alabama-based hospice provider agreed to pay $500,000 for allegedly violating the Civil Monetary Penalties Law, according to a release from the Department of Health and Human Services Office of Inspector General (OIG). OIG alleged that the hospice submitted claims to Medicare for hospice services that lacked recertifications of terminal illness, […]

OIG focuses on life expectancy in latest hospice audit

The Department of Health and Human Services Office of Inspector General (OIG) has suggested a hospice provider in Fairfield, Calif., repay $3.3 million to Medicare after its latest audit. The report, released earlier this month, alleged 21 of the 100 sampled claims over a two-year period did not support the associated beneficiary’s terminal prognosis. “Specifically, […]

OIG warns providers about COVID-19 vaccine fraud and abuse

The Department of Health and Human Services Office of Inspector General is reminding providers of the rules around administering the COVID-19 vaccine after complaints from patients charged for the vaccine and other reports of fraud and abuse around vaccine distribution. OIG is reminding all participating providers that they: must administer COVID-19 Vaccine with no out-of-pocket […]

Latest OIG audit suggests case-mix reductions a red flag for claim reviews

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently announced the results of an audit of Brookdale Home Health. The report came a familiar focus on ambulation, homebound and medical necessity. But there was another important note in the report that puts a fresh emphasis on case mix. The review […]

OIG releases message on telehealth reviews

The U.S. Department of Health and Human Services Principal Deputy Inspector General Christi A. Grimm recently released a message regarding telehealth. “Where telehealth and other remote access technologies were once a matter of convenience, the public health emergency made them a matter of safety for many beneficiaries,” says Grimm. A year later, there is strong […]

OIG announces investigation into nursing home discharges and evictions

The OIG announced plans to investigate whether nursing homes are following proper protocol when discharging and evicting residents. The OIG found that discharges and evictions were the most common compliant submitted to the Long-Term Care Ombudsman Program from 2011 to 2016. “Discharges which violate federal regulations are of great concern because in some cases they […]