OIG Plans New Compliance Guidance and Issues a New Toolkit

On Tuesday, Inspector General Grimm made several important announcements during her presentation at the Healthcare Compliance Association’s Compliance Institute.

Notable takeaways from her remarks include:

1.  The OIG will be releasing updated compliance guidance for the first time since 2008.  It is expected the guidance for Skilled Nursing Facilities and Managed Care will be released first followed by updated guidance for physician and hospital providers.

2.  The OIG has released a telehealth toolkit. The toolkit is designed to give providers a roadmap for identifying risks and potential payment errors within their own claims data.  The toolkit contains specific recommendations for data analysis and identifying providers and subsets of claims to include in your auditing and monitoring efforts.

3.  HCC coding is in the top 2 of OIG priorities.  The OIG identified $6.5 Billion in questionable payments last year related to HCC coding.   In light of all of the recent and ongoing enforcement activity in this area, providers are strongly encouraged to implement effective HCC coding controls.

Information regarding the OIG Compliance Guidance is available at: https://oig.hhs.gov/compliance/compliance-guidance/

The Telehealth Toolkit is available at: https://oig.hhs.gov/oei/reports/OEI-02-20-00723.asp

We are here to help.  The HBE team is available to assist you with all of your clinical documentation, coding and compliance program needs.  We routinely provide compliance partner services to large health systems as well as physician practices. Our services include:

  • Clinical documentation improvement reviews
  • Risk Assessments
  • Coding accuracy reviews
  • Policy and procedure development
  • Customized education and training for clinical and administrative staff

For more information, visit our website at: https://www.hbeadvisors.com

Recent Posts






Ready to discuss your project with us?