Nov 10th, 2017
Lately it seems that the Office of Inspector General’s (OIG) focus is on fraud and abuse of federal healthcare dollars via the False Claims Act; however, a case in Newark, N.J., has proven that the Anti-Kickback Statute also is being enforced in a big way. A Staten Island doctor, Ahmed El Soury, has been sentenced ...
In CMS
Jul 13th, 2017
The Office of Inspector General’s (OIG) combat on healthcare fraud, waste, and abuse of taxpayer’s money recovers $5 for every $1 spent on investigating, which gives them incentive to target more areas of fraud. The OIG’s latest and largest fraud takedown happened this month when opioid fraud was exposed with the help of state and federal law ...
Keep calm, know your responsibilities and risks, have a plan, and carry on. If your physician office receives a request for records from a health plan’s special investigations unit (SIU), your best defense is knowing the options, responsibilities, and duties attached to the request. Understand the SIU and FWA The SIU is part of the ...
Put these OIG compliance efforts on a high priority focus list for your provider. The Office of Inspector General’s (OIG) annual work plan for 2016 outlines significant new areas, as well as ongoing target areas, on which the federal agency will focus its reviews and audits of U.S. Department of Health and Human Services (HHS) ...
The Yates Memo provides a renewed focus on individual accountability in corporate misconduct. By Robert Pelaia, Esq., CPC, CPCO, and Jamie Ewing Note from Editor: There is a follow-up article to this article. On September 9, 2015, Sally Q. Yates, the current deputy attorney general for the United States Department of Justice (DOJ), issued a guidance ...