OIG
OIG Report Recommends CMS Use CERT Data to Identify High Risk Home Health Agencies
CMS Remains Opposed to Using CERT Data to Identify Improper Payments, Prefers TPE & RCD The Health and Human Services (HHS) Office of the Inspector General (OIG) recently released a report pertaining to home health agencies (HHA), The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home […]
Read MoreOIG Finds Medicare Part D Still Spending Millions for Hospice Drugs
Over recent years the Department of Health & Human Services Office of the Inspector General (OIG) and others have conducted analyses of spending outside of hospice while patients are on service and determined that Medicare may be paying separately for care (including prescription drugs under Part D) that should be the responsibility of the hospice. […]
Read MoreOIG Report Finds States Need to Do More on Background Checks for Long-Term Care Workers
A new report from the Office of Inspector General (OIG) of the Department of Health and Human Services finds that nine of the 11 states that concluded their participation in the National Background Check Program in 2017 and 2018 did not implement all of the selected Program requirements, primarily due to a lack of legislative […]
Read MoreAfter OIG Reports, House Committee Seeks More Info on Hospice Deficiencies
In response to two reports issued by the Department of Health and Human Services Office of the Inspector General (OIG) targeting hospice survey deficiencies and quality of care, House Ways and Means Committee Chair Richard E. Neal (D-MA) and Ranking Member Kevin Brady (R-TX) are seeking more information from Centers for Medicare & Medicaid Services […]
Read MoreUpdate on the OIG Report on Potential Abuse or Neglect of Patients
Earlier in July, the OIG released a report, CMS Could Use Medicare Data to Identify Instances of Potential Abuse or Neglect, (see NAHC Report coverage here) discussing how the OIG identified potential cases of abuse or neglect utilizing diagnosis codes on claims for beneficiaries treated in emergency rooms. In this report, the OIG also identified […]
Read MoreOIG Releases Two Reports Targeting Hospice Survey Deficiencies and Quality of Care
Earlier this week the HHS Office of the Inspector General (OIG) issued two reports representing in-depth study of findings from Medicare hospice recertification and complaint surveys. One report, Hospice Deficiencies Pose Risks to Medicare Beneficiaries, provides broad findings on frequencies of deficiencies and recommends greater public access to survey findings as well as increased CMS-sponsored […]
Read MoreOffice of Inspector General Continues Focus on Home Health Agencies
The Department of Health and Human Services (HHS), Office of the Inspector General (OIG) issues updates to its work plan on a monthly basis through out the year. Since our last report on the OIG’s recent activity updates (NAHC Report https://report.nahc.org/recently-added-oig-work-plan-item-may-impact-home-health-and-hospice-providers/), the OIG announced this month a revision of an issue for home heath agencies […]
Read MoreOIG: CMS & States Must Work Together on Background Checks for Long-Term Care Employees
The Centers for Medicare & Medicaid Services (CMS) must help states completely implement background checks for long-term caregiver employees, according to a new report released by the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). Nine million beneficiaries rely on long-term-care services each year for safe, dependable care and […]
Read MoreRecently Added OIG Work Plan Item May Impact Home Health and Hospice Providers
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) work planning is dynamic and adjustments are made throughout the year to meet priorities and to anticipate and respond to emerging issues. A Work Plan has been developed, made public, and updated monthly with new issues. This month, there are two new issues […]
Read MoreOIG: Non-Profit Hospital May Offer Free Home Care
A federal rule against offering patients free care does not prohibit a hospital from providing free home care if the goal is to reduce readmissions, according to an advisory opinion the Office of Inspector (OIG) General of the Department of Health and Human Services. The federal government forbids the provision of free services to patients […]
Read MoreOIG Adds Hospice Item to Work Plan
Recently the HHS Office of the Inspector General (OIG) added a hospice item to its work plan, Protecting Medicare Hospice Beneficiaries From Harm. The OIG is planning a study to determine the extent and nature of hospice deficiencies and complaints and identify trends. This study is a companion to Trends in Hospice Deficiencies and Complaints […]
Read MoreReports: Medicare Advantage Plans Improperly Denying Claims
— Anthem Adds Home Care Benefits Under Relaxed Medicare Advantage Rule Medicare Advantage plans are improperly denying medical insurance claims to patients and physicians, according to a report from the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) and a separate report in the New York Times. Roughly 20 […]
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