DHHS OIG: Banned Medicaid Providers Move to Other States to Stay in Business

Posted on August06, 2015
Medical providers banned from a Medicaid program in one state are able to participate in another state’s program, flouting regulations that are designed to stop such practices. A study by the U.S. Department of Health and Human Services Office of the Inspector General (OIG) found that about half of the states were unable to terminate improperly enrolled providers that were part of privately run Medicaid managed-care programs. The report from the federal auditor found that of the 1,539 healthcare providers…
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DHHS OIG Investigating Generic Drug Prices

Posted on April17, 2015
Members of Congress have requested the Office of Inspector General of the U.S. Department of Health and Human Services look into increases in generic drug prices on the Medicaid drug rebate program. As the cost of prescription drugs increases, brand-named medicine prices have been debated, but not lawmakers want the OIG to look into generic prices as well. Lawmakers are concerned that generic drug prices are increases faster than the inflation rate. In November 2014, data showed "prices for generics…
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Centers for Medicare & Medicaid Services Fail to Implement OIG Recommendations

Posted on March25, 2015
The U.S. Department of Health and Human Services Office of Inspector General released a report finding the Centers for Medicare & Medicaid Services (CMS) neglected to implement 25 sets of "significant recommendations" from the OIG. The estimated financial impact on taxpayers and beneficiaries is $24 billion. The recommended actions "would likely improve quality and patient safety, program integrity, financial and grants management, and contractor management" according to the report. Some of the recommendations that have not been implemented date back…
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OIG proposed rule: no statute of limitations on certain exclusion actions and other significant changes to exclusion authority

Posted on June30, 2014
Using the proposed rule, the OIG intends to update its exclusion regulations to codify changes made by the Affordable Care Act and other statutory authorities. Chief among the OIG’s proposals is an unlimited time period for bringing an affirmative exclusion action under Section 1128(b)(7) of the Social Security Act(7)). Read the entire article at Lexology
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The Benefits of the Case Management & Tracking System for Fraud, Waste & Abuse

Posted on April23, 2013
Our case management and case tracking system can replace time consuming, manual processes and increase your organization’s responsiveness to citizen concerns. Gain equality across all your cases by applying structure and integrity for capturing results. Comprehensive case data can be instantly available at your fingertips. CMTS was created to enrich your case management experience by being flexible, intuitive and secure. Below are some of the benefits of the CMTS technology. Automatic reports Streamlined processes Secured data Reduced time to close…
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The OIG: What you don’t know about fraud can hurt you

Posted on March20, 2013
The Office of the Inspector General (OIG) is a 1,700-member institution within the U.S. Department of Health and Human Services (HHS) that is charged with detecting fraud and abuse and “holding accountable those who do not meet program requirements or who violate Federal laws.” In other words, the OIG is the investigative and enforcement arm of HHS and its programs, including but not limited to the Centers for Medicare & Medicaid Services and the FDA. The OIG spends most of…
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HHS Inspector General Daniel Levinson to outline health care fraud and abuse enforcement initiatives during keynote address at HCCA’s 17th Annual Compliance Institute

Posted on February20, 2013
Health and Human Services Inspector General Daniel Levinson is expected to outline the agency's health care fraud and abuse enforcement efforts, and underscore its current compliance education and information resources, during his keynote address at the opening session of the 17th Annual Compliance Institute, Monday, April 22, 2013, the Health Care Compliance Association (HCCA) announced today. Conflict and stress resolution experts Peter and Susan Glaser will follow IG Levinson with their session, "Be Quiet, Be Heard: The Paradox of Persuasion." This…
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U.S. Department of Health & Human Services OIG announces Outlook 2013 Webcast

Posted on October24, 2012
OIG will launch its OIG Outlook 2013 webcast on October 24 at 11:00 a.m. EST.  This is a free event. Hear OIG top executives discuss emerging trends in combating fraud, waste, and abuse in Federal health care programs, OIG's top priorities for 2013, and upcoming projects outlined in the newly released OIG Work Plan. Sign up is not necessary. Who Should Tune In?  Health care providers, compliance officers, health care lawyers, trade association staff, health care program grant recipients, local,…
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