The OIG has issued their Semiannual Report to Congress for the period April 1, 2021 through September 30, 2021. The report highlights nearly...
OIG to Audit High Risk DRGs
The OIG has released the November update to their Work Plan. The most recent update includes plans to audit hospital claims billed with mechanical v...
Increased Enforcement for Risk Adjustment Coding
Risk adjustment coding has the been source of several recent large, false claims act settlements and is also the topic of a recent OIG Work Plan Audit...
Physician Emergency Department Encounters to be Audited
The August update to the OIG Work Plan has been released. The most recent update includes auditing of Medicare professional emergency depar...
OIG Report on CCM Overpayments
The OIG recently released a report that found CMS has continued to make overpayments for Chronic Care Management (CCM) services despite prior audit re...
OIG Conducts Audits of Medicare Payments for Polysomnography Services
The OIG has recently published several audit reports for polysomnography services provided to Medicare beneficiaries. The OIG selected samp...
OIG Releases Semi Annual Report to Congress
The OIG has issued their Semi Annual Report to Congress for the period, October 1, 2020 through March 31, 2021. The Spring 2021 Semi Annual ...
OIG Highlights Hospital Coding & Billing Risk Areas
With the slowing of COVID-19 cases in many parts of the country, CMS and the OIG are getting back to auditing high risk areas of regulatory compl...
OIG Recommends Targeted Audits of MS-DRGs
Last week, the OIG released a report on Part A claims for inpatient hospital stays from FY 2014 through FY 2019. The report indicates that approximate...
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