Oct 4th, 2017
The Center for Medicare & Medicaid Service’s (CMS) Fraud Prevention System generated 22 percent of investigations initiated by program integrity contractors in 2016. That means if you were audited by zone program integrity contractors (ZPIC), it might’ve been the $192 million data analytics program that raised the flag. ZPIC contractors told the Government Accounting Office ...
Oct 4th, 2017
​The Department of Health and Human Services Office of Inspector General (OIG)  announced in June that it would update the work plan monthly, to enhance transparency. In the September 15 update to the Work Plan, the new items posted are several examinations of Medicaid programs, including a review of five states to determine the extent to which Medicaid ...
In Audit
Aug 28th, 2017
“A Brooklyn Chiropractor Received Unallowable Medicare Payments for Chiropractice Services,” declares the Office of Inspector General (OIG) in an August 2017 report. According to the report, the New York chiropractor received at least $672,000 in improper payments over a two-year period. There’s a lesson to be learned here for chiropractic coders. First, Some Background Chiropractic ...
In Audit
Aug 15th, 2017
Effective June 15, 2017, the Office of Inspector General (OIG) now updates its Work Plan website, monthly. The OIG Work Plan sets forth various projects — including OIG audits and evaluations that are underway or planned — to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and Office of ...
In CMS
Aug 10th, 2017
The Office of Inspector General (OIG) says noncompliance of the three-day rule continues to cost Medicare millions of dollars, every year. In 2013-14, National Government Services (NGS), alone, reportedly overpaid New England providers an estimated $1.3 million. This estimate is based on a stratified random sample of 129 nonphysician outpatient services furnished within three days ...