Healthcare News & Insights

OIG revises Provider Self-Disclosure Protocol in favor of hospitals, docs

If a self-audit of your hospital uncovers a healthcare fraud scheme, it’s best to voluntarily notify the feds right away. Not only does it prevent the hospital from getting into more trouble, it can also be beneficial in terms of paying any associated penalties.

Banner year: OIG Audits and investigations net $6.9M

Sure, your hospital may be struggling financially to make ends meet in this era of providing quality care for less, but the Department of Health & Human Services (HHS) Office of Inspector General (OIG) isn’t suffering along with you. Instead it’s having a record breaking year thanks to its audits and investigations.

CMS’s response to PHI breaches examined

You know how your hospital is doing when it comes to guarding patients’ protected health information (PHI), but do you know how the Centers for Medicare & Medicaid Services (CMS) is doing?

Hospital has to return $589,705 in Medicare overpayments

Medicare paid Maine Medical Center — a 637-bed, acute-care hospital in Portland, ME — $340 million for 23,690 inpatient and 127,833 outpatient claims during calendar years 2009 and 2010. Now, the facility is returning $589,705 in Medicare overpayments.

OIG audits: Two hospitals owe Medicare $1 million

For hospitals, conforming to federal billing requirements demands 100% compliance, all the time.

Payback time: OIG audits uncover overpayments at 3 hospitals

The last thing any hospital administrator wants is to be audited by the Office of the Inspector General (OIG). Especially now that the Centers for Medicare & Medicaid Services on June 1st will launch the next leg of its Recovery Audit Prepayment Reviews — an aggressive program to deter overpayments due to fraud and errors.

Coupons for medical services?

A lot of people are familiar with daily deal sites. But now there’s a new wrinkle: Certain sites offer healthcare coupons. Providers who participate, however, need to be very careful.

Medicare wants back $38M it paid to emergency departments

Oops! Medicare says it wrongly paid more then $38 million in claims for outpatient emergency department  radiological services — and it wants its cash back.

Feds to review CMS auditing programs

Chances are audits are going to be getting even tighter in the near future. 

OIG: Less than half of states ready for the pandemic — is yours?

Perhaps you can never be 100% prepared for a massive health emergency. But a new OIG report indicates that many states and localities are falling well short of the mark in getting ready for a potential flu pandemic.