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 ...
In CMS
Feb 28th, 2017
New compliance program guidance has been issued by the Fraud Section of the Department of Justice (DOJ), according to an article published in the AHLA Weekly. Although the “Evaluation of Corporate Compliance Programs” (Guidance) is not specific to the healthcare industry, it does provide a practical set of benchmarks against which the audit & compliance committee, in ...
Time to give your physician office’s compliance plan an annual preventive exam. The Office of Inspector General (OIG) publishes annually a Work Plan describing new, ongoing, and revised areas within the U.S. Department of Health and Human Services (HHS) it will investigate throughout the year for potential fraud, waste, and abuse. It’s wise for providers ...
Jan 20th, 2017
The American Health Lawyers association reported the following in its weekly Fraud and Abuse update: The government won or negotiated more than $2.5 billion in healthcare fraud judgments and settlements in fiscal year (FY) 2016, the Departments of Health and Human Services (HHS) and Justice (DOJ) said in their Health Care Fraud and Abuse Control Program Annual ...
In Audit
Jan 10th, 2017
If you haven’t stumbled on the treasure trove of information in the Office of Inspector General’s (OIG) Media section of their website, it’s time you found it. OIG now keeps you informed on fraud, enforcement, and compliance via podcast. The podcasts are found on the OIG website with Mike Kane, Office of External Affairs, discussing the monthly ...