Tag Archives: OIG

National Health Care Fraud Abuse Control Program Reports Record Recoveries and Return on Investment

Through their Health Care Fraud Abuse Control program (“HCFAC”), the United States Departments of Justice (“DOJ”) and the United States Department of Health and Human Services (“HHS”) have recovered more than $19 billion from health care providers over the last … Continue reading

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Medicare Payments for Zombies: OIG reveals that Medicare Advantage payments sometimes outlive beneficiaries

Just in time for Halloween, in a Medicare audit, the Office of the Inspector General of the Department of Health and Human Services has found that $23 million in Medicare expenditures in 2011 were paid inappropriately after the beneficiary had … Continue reading

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Exclusion From Federal Health Care Programs: New Guidance From The United States HHS OIG

The United States Department of Health and Human Services Office of the Inspector General (OIG) has issued a Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs (“the Bulletin”).  The Bulletin replaces the previous … Continue reading

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OIG: PODs “Inherently Suspect”

On Tuesday, the federal Office of the Inspector General (“OIG”) issued a Special Fraud Alert (“Fraud Alert”) detailing the OIG’s concerns with Physician-Owned Entities.  Specifically, the alert dealt with physician-owned distributorships, or PODs.  PODs are typically entities that make money … Continue reading

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New York State Allegedly Overbilled $15 Billion for State-Operated Facilities for Developmentally Disabled

On May 17, 2012, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a report that found Medicaid overpayments to New York State-operated developmental centers. The OIG concluded that, in 2009, State-operated  facilities for the developmentally disabled … Continue reading

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OIG finds DOH should refund nearly $8 million to federal government

In a recent audit of the New York State Department of Health (DOH), the Office of the Inspector General of the United States Department of Health and Human Services (OIG) found that several New York City area providers billed Medicaid … Continue reading

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Analysis on GAO Report: $102 Million Spent on Auditing Fees to Identify Less Than $20 Million in Overpayments

The Federal Government Accountability Office (GAO) has determined that a program to fight fraud in the Medicaid health system for the poor has cost the federal taxpayers at least $102 million in auditing fees since 2008 while finding less than … Continue reading

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United States HHS OIG Reviewing Self Disclosure Protocol for Federal Health Care Programs

The federal government’s Office of the Inspector General (“OIG”), part of the United States Department of Health and Human Services, is considering revising its self-disclosure protocol to provide additional guidance to federal health care program providers.  The OIG is soliciting … Continue reading

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OIG Releases Report on Medicaid Rates for New York State-Operated Developmental Centers

The Office of Inspector General (“OIG”) released a report yesterday based on its review of the reimbursement rates for New York State-operated developmental centers.   The report found that the Medicaid daily rate for state-operated developmental centers was inflated, and that … Continue reading

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OMIG 2012-2013 Work Plan: A Brief Overview

“Fighting Fraud.  Improving Integrity and Quality.  Saving Taxpayer Dollars.” This phrase appears on each page of the newly released New York State Office of the Medicaid Inspector General (OMIG) State Fiscal Year 2012-2013 Work Plan. On the Executive Summary page, … Continue reading

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