Tag: OIG

OIG report finds EHRs are being improperly reviewed by CMS

The Office of the Inspector General (OIG) recently released a report titled, “CMS and Its Contractors Have Adopted Few Program Integrity Practices to Address Vulnerability in EHRs” that finds that few CMS contractors from the Centers for Medicare & Medicaid Services (CMS) were reviewing electronic health records properly. According to the OIG report, electronic health […]

OIG releases 2014-2018 strategic plan and top management issues

The Office of the Inspector General (OIG) has released their strategic plan for 2014-2018. Their goals include: Fight fraud, waste, and abuse Promote quality, safety, and value Secure the future Advance excellence and innovation To read the full report, click here. The OIG also released their annual summary of the most significant management and performance […]

OIG study recommends developing new quality measure

A new Office of the Inspector General (OIG) study has recommended to the Centers of Medicare & Medicaid Services (CMS) that they develop a quality measure that describes nursing home resident hospitalization rates. The OIG study states: Nursing homes hospitalize residents when physicians and nursing staff determine that residents require acute-level care. Such transfers to […]

OIG releases report on Medicare A and B redeterminations

Earlier this month, the Office of the Inspector General (OIG) released a report titled, “The First Level of the Medicare Appeals Process, 2008-2012: Volume, Outcomes, and Timeliness”. According to the OIG, the Medicare appeals process serves as an important protection for beneficiaries and providers. Their study represents the first examination of redetermination, i.e., the first […]

OIG releases new report on RAC program and improper payments

On September 3, the Office of Inspector General (OIG) released a report titled, “Medicare Recovery Audit Contractors and CMS’s Actions To Address Improper Payments, Referrals of Potential Fraud, and Performance.” The report found that in 2010 and 2011, Recovery Audit Contractors (RAC) identified half of all claims they reviewed as having resulted in improper payments […]