The OIG has issued their Semiannual Report to Congress for the reporting period October 1, 2019 to March 31, 2020.  The report details the OIG’s ongoing work through investigations and enforcement actions which include:

• 605.2 million in recoveries from audits
• 1.51 billion in investigative recoveries
• 443 criminal actions
• 370 civil actions
• 903 excluded individuals and entities

The Semiannual Report also highlights the specific types of services included in the recoveries, many of which, are currently included in the OIG Work Plan.  Some of the Medicare specific investigations included the following:

• Post-acute care transfers
• Chronic Care Management (CCM) services
• Orthotic devices
• EHR incentive payments
• Medicare Advantage payments

We recommend you read the complete Semiannual Report to identify risks that are pertinent to your organization.  Risk areas identified within this report and the Work Plan should be incorporated in to your auditing and monitoring efforts. 

HBE’s team of experts is available to assist you with conducting risk assessments, routine auditing and monitoring, policy and procedure development as well as customized education and training for your clinical and administrative staff.

The entire OIG Semiannual Report can be accessed here: https://oig.hhs.gov/reports-and-publications/archives/semiannual/2020/2020-spring-sar.pdf